Provider Demographics
NPI:1508376120
Name:SUMMERS, ROBYN AMANDA (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:AMANDA
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:HUSAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10023 DAYFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1697
Mailing Address - Country:US
Mailing Address - Phone:770-540-5955
Mailing Address - Fax:
Practice Address - Street 1:10023 DAYFLOWER WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1697
Practice Address - Country:US
Practice Address - Phone:770-540-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW139741041C0700X
GACSW0067961041C0700X
TNLSW00000071131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical