DR. WALTER WORLEY FAIN III ED.D. - NPI 1972589638

Q: What is Walter Fain's NPI number?

The NPI number for Walter Fain is 1972589638. It was assigned to this individual provider in the NPPES registry on December 15, 2005.

Q: What is Walter Fain's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Walter Fain was last updated on February 2, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Dr. Walter Worley Fain Iii Ed.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WALTER WORLEY FAIN III ED.D. (NPI 1972589638) is an individual clinical provider in Maryville, Tennessee, licensed in Tennessee (P0000001139) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1972589638

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. WALTER WORLEY FAIN IIICredential: ED.D.

Location Address659 MORGANTON SQUARE DRMaryville, TN 37801-4763

Mailing Address659 Morganton Square DrMaryville, TN 37801-4763 · (865) 983-3348 · Fax (615) 296-4440

Phone(865) 983-3348

Fax(615) 296-4440

Sole ProprietorYes

Enumeration DateDecember 15, 2005

Last NPPES UpdateFebruary 2, 2009

✔ NPI 1972589638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in TN · P0000001139

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

659 MORGANTON SQUARE DR, Maryville, TN 37801

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Other Identifiers 3

Other62-1424098-379200000TN · Champus Number

Other2004080TN · Blue Cross Number

Medicare PIN36875031TN

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY JOANN FAUCETT LCSW

Social Worker (Clinical)