Jonathan McCollum, LCSW
Individual provider Active NPI Clinical Social Worker · Maryville, TN
NPI 1003002734 · NPPES record last updated Jun 11, 2014
Key facts
- NPI
- 1003002734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6020 (TN)
- Practice address
- 210 Simmons St
Maryville, TN 37801-4750 - Phone
- (865) 970-9800
- Fax
- (865) 374-7129
- NPI assigned
- Sep 17, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- River Region Psychiatry Associates, LLC
Practice addresses (Care Compare)
111 Ctr Park Dr
Suite 1003
Knoxville, TN 37922-2125
Phone (828) 788-2441
1401 Applewood Dr
Suite 1
Dalton, GA 30720-2699
Phone (706) 460-4100
3010 Greystone SQ
Jackson, TN 38305-3589
Phone (731) 467-5515
651 Dunlop LN
Clarksville, TN 37040-5015
Phone (931) 502-1262
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140710001338 | TN | Practitioner - Clinical Social Worker | 9234354077 |
Reassigns benefits to 1 organization Practice locations: Knoxville, TN |
| I20230731003068 | GA | Practitioner - Clinical Social Worker | 9234354077 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles (2 of 19)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Region Psychiatry Associates LLC | Current |
Accepting new patients | |
| Parkwest Medical Center | Past | Accepting new patients |
Locations
233 Winton M Blount Loop
Montgomery, AL 36117
Phone (334) 207-3188
1401 Applewood Dr
Ste 1
Dalton, GA 30720
Phone (706) 270-5003
4015 S Cobb Dr SE
Ste 115
Smyrna, GA 30080
Phone (770) 431-2354
2160 Fountain Dr
Ste 100
Snellville, GA 30078
Phone (678) 344-8268
651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000
109 Holiday Ct
Ste D10
Franklin, TN 37067
Phone (615) 339-4642
Networks
- KY PPO C-SNP
- devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
- devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
- KY PPO
- MS PPO C-SNP
- TN PPO
- AL HMO
- devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
- FL HMO
- AL HMO D-SNP
- MS PPO D-SNP
- FL HMO D-SNP
- TN PPO C-SNP
- devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
- FL HMO C-SNP
- MS PPO
- devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | 6020 | TN | Yes |
Addresses
Primary practice location
210 Simmons St
Maryville, TN 37801-4750
Mailing address
1451 Dowell Springs Blvd
Knoxville, TN 37909-2441
Phone (865) 374-7123
Other providers in Maryville, TN
- Matthew J McCarty
- Jaime Lee McClellan
- Jennifer McClements
- Chad Andrew McClure
- Leighanna Brooke McClure
- Timothy P McConnell
- Karissa McCoy
- Atlanta Gayle Russell McCravey
- Amanda Marianne McEntee
- Alicia McFalls
All providers in Maryville, TN · Clinical Social Worker in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.