Most Relevant Information
Provider Data
| NPI Number: | 1003002734 |
| Provider Name: | JONATHAN MCCOLLUM LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/17/2007 |
| Last Updated: | 06/11/2014 |
Provider Practice Location
210 SIMMONS ST
MARYVILLE
TN
378014750
Practice Location Phone/Fax
| Phone: | 8659709800 |
| Fax: | 8653747129 |
Provider Mailing Location
1451 DOWELL SPRINGS BLVD
KNOXVILLE
TN
379092441
Provider Mailing Phone/Fax
| Phone: | 8653747123 |
| Fax: | 8653747129 |