Provider Demographics
NPI:1457413981
Name:ROGERS VIARS, STEPHANIE A (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:ROGERS VIARS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 POPLAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-4516
Mailing Address - Country:US
Mailing Address - Phone:865-394-8052
Mailing Address - Fax:
Practice Address - Street 1:245 S PETERS RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5204
Practice Address - Country:US
Practice Address - Phone:865-394-8052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1179104100000X
TN0011791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1508723Medicaid
TN3920119Medicare PIN