Provider Demographics
NPI:1356567002
Name:WINECOFF, DAVID MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:WINECOFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 SUTHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4338
Mailing Address - Country:US
Mailing Address - Phone:865-450-9702
Mailing Address - Fax:865-450-9702
Practice Address - Street 1:3711 SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4338
Practice Address - Country:US
Practice Address - Phone:865-450-9702
Practice Address - Fax:865-450-9702
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP-1465103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4106843OtherBLUE CROSS PROVIDER #
TN3684074Medicaid
TN3684074Medicaid