Provider Demographics
NPI:1578653523
Name:SINGLETON, JOHN PHILLIP (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PHILLIP
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E MAIN ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4257
Mailing Address - Country:US
Mailing Address - Phone:423-246-9800
Mailing Address - Fax:423-246-5247
Practice Address - Street 1:108 E MAIN ST
Practice Address - Street 2:SUITE 215
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4257
Practice Address - Country:US
Practice Address - Phone:423-246-9800
Practice Address - Fax:423-246-5247
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNIP 5841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3691260Medicare ID - Type UnspecifiedMEDICARE NUMBER