Provider Demographics
NPI:1184088775
Name:SANTOS-SILVA, KRISTEN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:SANTOS-SILVA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22301
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-0301
Mailing Address - Country:US
Mailing Address - Phone:315-489-4512
Mailing Address - Fax:
Practice Address - Street 1:210 SIMMONS ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4750
Practice Address - Country:US
Practice Address - Phone:865-970-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21491104100000X
TN69441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker