Provider Demographics
NPI:1871209148
Name:AHMED, SUMMER (LMSW)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N WILCOX DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4967
Mailing Address - Country:US
Mailing Address - Phone:423-218-9214
Mailing Address - Fax:
Practice Address - Street 1:1201 N WILCOX DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4967
Practice Address - Country:US
Practice Address - Phone:423-218-9214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000013279104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty