Provider Demographics
NPI:1023723855
Name:HYRCHUK, KARISSA (LCSW)
Entity type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:HYRCHUK
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 1:126 S SAINT MARKS AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-4859
Mailing Address - Country:US
Mailing Address - Phone:423-505-7033
Mailing Address - Fax:
Practice Address - Street 1:1360 MACKEY BRANCH DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3225
Practice Address - Country:US
Practice Address - Phone:423-443-3336
Practice Address - Fax:423-464-7510
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN76251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical