Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | P 532 | TN |
Y | 103G00000X | Clinical Psychologist | P 532 | TN |
Y | 103TC0700X | Clinical Psychologist | P 532 | TN |
NPI | 1346372042 |
---|---|
Provider Name | L Michael Sherrod |
First Address | Knoxville, TN 37923-4404 |
Second Address | Knoxville, TN 37923-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 18/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014156 | BLUE CROSS BLUE SHIELD TN (01) | TN |
226482000 | MAGELLAN (01) | TN |
23871 | CIGNA BEHAVIORAL HEALTH (01) | TN |
2579877 | COMPSYCH (01) | TN |
3683167 | (05) | TN |
5226618 | AETNA (01) | TN |
602005019 | CARITEN (01) | TN |
621203069 | CIGNA (01) | TN |
621203069 | TENNESSEE BEHAVIORAL HEAL (01) | TN |
621203069-01 | UNITED HEALTHCARE (01) | TN |
932 | PRIME PROVIDER SYSTEMS (01) | TN |
9455777 | PHCS (01) | TN |