Provider Demographics
NPI:1013778448
Name:PROCTOR, RIANN JOAN-GARBETT (LCSW)
Entity Type:Individual
Prefix:
First Name:RIANN
Middle Name:JOAN-GARBETT
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 STONE PONY LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7595
Mailing Address - Country:US
Mailing Address - Phone:319-270-7775
Mailing Address - Fax:
Practice Address - Street 1:525 STONE PONY LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-7595
Practice Address - Country:US
Practice Address - Phone:319-270-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN86061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty