Provider Demographics
NPI:1437812187
Name:HUNSUCKER, CARLYE ELIZABETH (LMSW)
Entity Type:Individual
Prefix:
First Name:CARLYE
Middle Name:ELIZABETH
Last Name:HUNSUCKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 WILDERNESS DR
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8707
Mailing Address - Country:US
Mailing Address - Phone:423-312-0993
Mailing Address - Fax:
Practice Address - Street 1:1960 WILDERNESS DR
Practice Address - Street 2:
Practice Address - City:TALBOTT
Practice Address - State:TN
Practice Address - Zip Code:37877-8707
Practice Address - Country:US
Practice Address - Phone:423-312-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12590104100000X
TNLSW0000012590104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker