Provider Demographics
NPI:1982976486
Name:SERGENT, SYLVIA J (PHD, LCSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:J
Last Name:SERGENT
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:4833 GETTYSBURG RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-3000
Practice Address - Country:US
Practice Address - Phone:865-604-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1030OtherPROFESSIONAL LICENSE