Provider Demographics
NPI:1841649027
Name:BEARDEN, HOLLY ASHTON (LMSW)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ASHTON
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ASHTON
Other - Last Name:CROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 W SPRINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5158
Mailing Address - Country:US
Mailing Address - Phone:656-379-7118
Mailing Address - Fax:
Practice Address - Street 1:255 E WATT ST
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701
Practice Address - Country:US
Practice Address - Phone:865-273-1616
Practice Address - Fax:865-273-1645
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 171M00000X
TNLSW11254104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator