Individual provider Active NPI

Stephanie Anderson, LPC-MHSP

  • Professional Counselor
  • Lebanon, TN
National Provider Identifier
1013434794
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5899 Issued in TN
Practice address
206 Hickory Pointe Dr
Lebanon, TN 37087-5009
Phone
(937) 554-6730
NPI assigned
Aug 24, 2017
Last updated
May 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII131054 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 1526 TN
Professional Counselor 101YP2500X C2103159 OH
Professional Counselor 101YP2500X 5899 TN Primary

Addresses

Primary practice location

206 Hickory Pointe Dr
Lebanon, TN 37087-5009

Mailing address

206 Hickory Pointe Dr
Lebanon, TN 37087-5009
Phone (937) 554-6730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612003522 TN Practitioner - Mental Health Counselor 7911449343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2839 Hwy 231 N
Suite 101
Shelbyville, TN 37160-7448
Phone (931) 488-4014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCDCIII131054OHMDAddiction (Substance Use Disorder) Counselor
1526TNMDAddiction (Substance Use Disorder) Counselor
C2103159OHMDProfessional Counselor
5899TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Recovery of Middle Tennessee, LLC CurrentSince May 1, 2024 Accepting new patients
Cedar Recovery Center of Middle Tennessee, LLC Professional CurrentSince May 1, 2024 Accepting new patients

Locations

2636 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 680-0110

5000 Crossings Cir
Ste 103
Mt Juliet, TN 37122
Phone (615) 208-9549

2839 Highway 231 N
Ste 101
Shelbyville, TN 37160
Phone (931) 488-4014

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1013434794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HICKORY POINTE DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370875009",
            "telephone_number": "937-554-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 HICKORY POINTE DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370875009",
            "telephone_number": "937-554-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STEPHANIE",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII131054",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1526",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C2103159",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.