Provider Demographics
NPI:1932246493
Name:SCHAMBACH, STACY C (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:C
Last Name:SCHAMBACH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 WHITTLE SPRINGS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1513
Mailing Address - Country:US
Mailing Address - Phone:865-688-0661
Mailing Address - Fax:865-688-5780
Practice Address - Street 1:4420 WHITTLE SPRINGS RD
Practice Address - Street 2:SUITE B
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1513
Practice Address - Country:US
Practice Address - Phone:865-688-0661
Practice Address - Fax:865-688-5780
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical