Provider Demographics
NPI:1053001800
Name:WELCH, LAURENCE (LMSW)
Entity type:Individual
Prefix:
First Name:LAURENCE
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10434 JACKSON OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3293
Mailing Address - Country:US
Mailing Address - Phone:865-588-3173
Mailing Address - Fax:
Practice Address - Street 1:10434 JACKSON OAKS WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3293
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000143971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical