Provider Demographics
NPI:1578094140
Name:BURROUGHS, MARCI SONDRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCI
Middle Name:SONDRA
Last Name:BURROUGHS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N PETERS RD STE 155
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4927
Mailing Address - Country:US
Mailing Address - Phone:865-696-7332
Mailing Address - Fax:865-761-8198
Practice Address - Street 1:9111 CROSS PARK DR SUITE E111
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4506
Practice Address - Country:US
Practice Address - Phone:865-696-7332
Practice Address - Fax:865-761-8198
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2109103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling