Provider Demographics
NPI:1437628930
Name:STEINBRUEGGE, SAMUEL BAXTER (LCSW)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:BAXTER
Last Name:STEINBRUEGGE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:BETH
Other - Last Name:STEINBRUEGGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5568
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37802-5568
Mailing Address - Country:US
Mailing Address - Phone:865-309-5427
Mailing Address - Fax:866-318-9025
Practice Address - Street 1:519 W LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4701
Practice Address - Country:US
Practice Address - Phone:865-309-5427
Practice Address - Fax:866-318-9025
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN72581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical