Provider Demographics
NPI:1295974319
Name:WAYNE E. TASKER AND ASSOCIATES, INC.
Entity type:Organization
Organization Name:WAYNE E. TASKER AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TASKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:423-581-8844
Mailing Address - Street 1:1329 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3728
Mailing Address - Country:US
Mailing Address - Phone:423-581-8844
Mailing Address - Fax:423-318-3050
Practice Address - Street 1:1329 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3728
Practice Address - Country:US
Practice Address - Phone:423-581-8844
Practice Address - Fax:423-318-3050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2658103TC0700X
TNMD146352084P0800X
TNPA1050363AM0700X
TNAPN11054363LA2200X
TNAPN12613364SP0808X
TNAPN10446363LF0000X
TNLSW50361041C0700X
TNLSW49231041C0700X
TNLSW49351041C0700X
TNP2028103TC0700X
TNP2741103TC0700X
TNLSW12081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty