Active NPI
Jolene Underwood, LPC-MHSP
- Professional Counselor
- Franklin, TN
National Provider Identifier
1003552738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5343
- Practice address
- 1650 Murfreesboro Rd
Franklin, TN 37067-5080 - Phone
- (615) 200-6101
- NPI assigned
- May 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5343 | TN | Primary |
Addresses
Primary practice location
1650 Murfreesboro Rd
Franklin, TN 37067-5080
Mailing address
111 Stammer Farms Blvd
Chapel Hill, TN 37034
Phone (954) 303-3611
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.newmoonrisingwellness.com | Health Information Exchange (HIE) | In Our Light LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 2, 2024 through Apr 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5343 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1003552738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 STAMMER FARMS BLVD",
"city": "CHAPEL HILL",
"state": "TN",
"postal_code": "37034",
"telephone_number": "954-303-3611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 MURFREESBORO RD",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370675080",
"telephone_number": "615-200-6101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "JOLENE",
"credential": "LPC-MHSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-05",
"last_updated": "2022-05-05",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "TN",
"license": "5343",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://www.newmoonrisingwellness.com",
"affiliation": "Y",
"endpointDescription": "website",
"affiliationName": "In Our Light LLC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1650 Murfreesboro Rd",
"city": "Franklin",
"state": "TN",
"country_code": "US",
"postal_code": "370675080",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Franklin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.