Basic Information
| Provider Information | |||||||||
| NPI: | 1386625325 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUNDERS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | EARL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | LICENSED CLINICAL SO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1923 SULPHUR SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | MORRISTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378135654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003553565 | ||||||||
| FaxNumber: | 4237142355 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 EMORY RD | ||||||||
| Address2: | |||||||||
| City: | BLAINE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377092420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659334110 | ||||||||
| FaxNumber: | 8659334729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 03/21/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LSW4903 | TN | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | C002826 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.