Provider Demographics
NPI:1902041791
Name:PSYCHOEDUCATIONAL NETWORK
Entity Type:Organization
Organization Name:PSYCHOEDUCATIONAL NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PRISLOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:865-579-2727
Mailing Address - Street 1:7417 KINGSTON PIKE STE 103
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5616
Mailing Address - Country:US
Mailing Address - Phone:865-579-2727
Mailing Address - Fax:865-579-2522
Practice Address - Street 1:7417 KINGSTON PIKE STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5616
Practice Address - Country:US
Practice Address - Phone:865-579-2727
Practice Address - Fax:865-579-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty