Provider Demographics
NPI:1962644344
Name:SUAREZ, JAMES CLAUDE
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CLAUDE
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:CLAUDE
Other - Last Name:SUAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:825 WHITESBURG DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-8959
Mailing Address - Country:US
Mailing Address - Phone:865-740-8811
Mailing Address - Fax:
Practice Address - Street 1:428 E SCOTT AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-6362
Practice Address - Country:US
Practice Address - Phone:865-740-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ004679Medicaid