Provider Demographics
NPI:1548535917
Name:SANDS, KATHRYN LEN
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEN
Last Name:SANDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 E OLD TOPSIDE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-5038
Mailing Address - Country:US
Mailing Address - Phone:865-254-0168
Mailing Address - Fax:
Practice Address - Street 1:9220 PARKWEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37379
Practice Address - Country:US
Practice Address - Phone:865-247-6754
Practice Address - Fax:615-514-9604
Is Sole Proprietor?:No
Enumeration Date:2012-03-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator