Judith Lynn Pesch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6082769 Issued in TN

Practice address

386 Highway 91
Elizabethton, TN 37643-6060

Phone

(423) 946-5576

Fax

(423) 542-3240

NPI assigned

Feb 25, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1285956656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 COLONIAL RIDGE RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047626",
            "telephone_number": "423-926-3075",
            "fax_number": "423-542-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 HIGHWAY 91",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376436060",
            "telephone_number": "423-946-5576",
            "fax_number": "423-542-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCH",
        "first_name": "JUDITH",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6082769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Elizabethton, TN
• Providers in Elizabethton, 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 Feb 25, 2010; 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.