Provider Demographics
NPI:1548707615
Name:WYANT, BILLIE J (LCSW)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:J
Last Name:WYANT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 WALTER GARRETT RD
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:TN
Mailing Address - Zip Code:38363-5018
Mailing Address - Country:US
Mailing Address - Phone:707-272-9112
Mailing Address - Fax:
Practice Address - Street 1:359 WALTER GARRETT RD
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-5018
Practice Address - Country:US
Practice Address - Phone:707-272-9112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79493104100000X
101Y00000X, 171M00000X
CA1007031041C0700X
TN82541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator