Provider Demographics
NPI:1578608311
Name:CARSON-WEBB, JONNA GAIL (PSYD)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:GAIL
Last Name:CARSON-WEBB
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21533
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37424-0533
Mailing Address - Country:US
Mailing Address - Phone:423-892-1795
Mailing Address - Fax:423-414-2979
Practice Address - Street 1:7030 LEE HWY STE 102
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6795
Practice Address - Country:US
Practice Address - Phone:423-892-1795
Practice Address - Fax:423-414-2979
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1986103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist