Provider Demographics
NPI:1902837297
Name:STILLMAN, DENISE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:M
Last Name:STILLMAN
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 1:6231 HIGHLAND PLACE WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4083
Mailing Address - Country:US
Mailing Address - Phone:865-264-2400
Mailing Address - Fax:865-588-6406
Practice Address - Street 1:1128 E WEISGARBER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2674
Practice Address - Country:US
Practice Address - Phone:865-264-2400
Practice Address - Fax:865-588-6406
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982651Medicaid
TN3685221Medicare ID - Type UnspecifiedMEDICARE