Jessica Leanne Balzer, LCSW
Individual provider Active NPI Clinical Social Worker · Andersonville, TN
NPI 1568097665 · NPPES record last updated Aug 9, 2022
Key facts
- NPI
- 1568097665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8165 (TN)
- Practice address
- 3382 Andersonville Hwy
Andersonville, TN 37705-3816 - Phone
- (423) 823-2156
- NPI assigned
- Mar 9, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8165 | TN | MD | Clinical Social Worker |
| 11607 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11607 | TN | |
| Clinical Social Worker | 1041C0700X | 8165 | TN | Yes |
Addresses
Primary practice location
3382 Andersonville Hwy
Andersonville, TN 37705-3816
Mailing address
1200 Saybrook LN
Knoxville, TN 37923-2063
Phone (423) 823-2156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11607 | Other | TN | TN DEPARTMENT OF HEALTH LMSW LICENSURE |
| 8165 | Other | TN | TN DEPARTMENT OF HEALTH BOARD OF SOCIAL WORKERS |
Other providers in Andersonville, TN
- Andersonville TN Holdco LLC
- Andersonville TN Opco, LLC
- Kandi Bailey
- Divinity Health Diagnostics,LLC
- Keri Powell Galloway
- Natalie Hamel
- Hatmaker Family Pharmacy Inc
- Hometown Health PLLC
All providers in Andersonville, TN · Clinical Social Worker in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.