Provider Demographics
NPI:1548283120
Name:EHRNSCHWENDER, KATHY B (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:B
Last Name:EHRNSCHWENDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9217 PARK WEST BLVD
Mailing Address - Street 2:# D-1
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4404
Mailing Address - Country:US
Mailing Address - Phone:865-691-2425
Mailing Address - Fax:
Practice Address - Street 1:8424 CORTELAND DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2119
Practice Address - Country:US
Practice Address - Phone:865-567-8954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001806103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3017674OtherBC/BS
TN3686247Medicare ID - Type UnspecifiedMEDICARE/MEDICAID