Provider Demographics
NPI:1902274129
Name:KILGORE, FRANK ADAM (LCSW)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ADAM
Last Name:KILGORE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 3RD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37407-1422
Mailing Address - Country:US
Mailing Address - Phone:423-648-9939
Mailing Address - Fax:423-648-9935
Practice Address - Street 1:3000 3RD AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37407-1422
Practice Address - Country:US
Practice Address - Phone:423-648-9939
Practice Address - Fax:423-648-9935
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLCSW61561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical