Provider Demographics
NPI:1174180111
Name:JUSTICE, JARROD LYNN (MAMFT)
Entity type:Individual
Prefix:MR
First Name:JARROD
Middle Name:LYNN
Last Name:JUSTICE
Suffix:
Gender:M
Credentials:MAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PERIMETER PARK RD STE A
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2200
Mailing Address - Country:US
Mailing Address - Phone:865-409-5001
Mailing Address - Fax:865-415-3311
Practice Address - Street 1:110 PERIMETER PARK RD STE A
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2200
Practice Address - Country:US
Practice Address - Phone:865-409-5001
Practice Address - Fax:865-415-3311
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1674106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist