Brenda Joyce Southerland, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3535 Issued in TN

Practice address

3508 Maryville Pike
Suite E
Knoxville, TN 37920-6195

Phone

(865) 579-5886

Fax

(865) 579-5884

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Senior Care Consultants Inc

  • Clinical Social Worker
  • Knoxville, TN
  • NPI 1295771269
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124044110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 MARYVILLE PIKE",
            "address_2": "SUITE E",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379206195",
            "telephone_number": "865-579-5886",
            "fax_number": "865-579-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 MARYVILLE PIKE",
            "address_2": "SUITE E",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379206195",
            "telephone_number": "865-579-5886",
            "fax_number": "865-579-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERLAND",
        "first_name": "BRENDA",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3132589",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3920199",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Occupational Pulmonary Services
• Southeastern Psychiatry Specialists, LLC
• Southeastern Retina Associates, P.C.
• Stephen K Souther, M.D.
• Audra Joy Southerland
• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Southern Home Care Services, Inc. (All Ways Caring HomeCare)
• Southern Medical Group PLLC
• Southern Orthocare, Inc
• Southland Behavioral Health

• Clinical Social Worker in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.