Provider Demographics
NPI:1265713523
Name:RIDDELL, KARI (LCSW)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:RIDDELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:HOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5410 HOMBERG DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5031
Mailing Address - Country:US
Mailing Address - Phone:865-387-5062
Mailing Address - Fax:
Practice Address - Street 1:5410 HOMBERG DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5031
Practice Address - Country:US
Practice Address - Phone:865-387-5062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN65811041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ069903Medicaid