Kathleen Marie Custard, LMSW is a
Social Worker - Clinical based in Harriman, Tennessee. Kathleen Marie Custard is licensed to practice in Tennessee (license number LSW0000008600) and her current practice location is
2305 N Gateway Ave Unit 2, Harriman, Tennessee. She can be reached at her office (for appointments etc.) via phone at
(423) 240-4144.
NPI number for Kathleen Marie Custard is 1285331025 and her current mailing address is 2305 N Gateway Ave Unit 2, Harriman, Tennessee. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1285331025.
Healthcare Provider's Profile
| Full Name | Kathleen Marie Custard |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2305 N Gateway Ave Unit 2, Harriman, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1285331025
- Provider Enumeration Date: 02/13/2023
- Last Update Date: 02/13/2023
Medical Identifiers
Medical identifiers for Kathleen Marie Custard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285331025 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | LSW0000008600 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathleen Marie Custard is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kathleen Marie Custard, LMSW
2305 N Gateway Ave Unit 2,
Harriman, TN 37748-8709
Ph: (423) 240-4144 | Kathleen Marie Custard, LMSW
2305 N Gateway Ave Unit 2,
Harriman, TN 37748-8709
Ph: (423) 240-4144 |
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