Individual provider Active NPI

Madison Nichole Appleba, LCSW

  • Mental Health Counselor
  • Johnson City, TN
National Provider Identifier
1053287854
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
251S00000X Issued in TN
Practice address
207 E Main St Ste 2E
Johnson City, TN 37604-5749
Phone
(423) 430-9362
Fax
(423) 830-0767
NPI assigned
Oct 17, 2025
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 251S00000X TN Primary

Addresses

Primary practice location

207 E Main St Ste 2E
Johnson City, TN 37604-5749

Mailing address

207 E Main St Ste 2E
Johnson City, TN 37604-5749
Phone (423) 430-9362

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
I20260515001779 TN Practitioner - Clinical Social Worker 2961971254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

207 E Main St
Suite 2E
Johnson City, TN 37604-5710

207 E Main St
Suite 2E
Johnson City, TN 37604-5749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
251S00000XTNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquil JC, LLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

207 E Main St
Ste 2E
Johnson City, TN 37604
Phone (423) 282-2516

Organizations & group practices 1

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": "1760659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1053287854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST STE 2E",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045749",
            "telephone_number": "423-430-9362",
            "fax_number": "423-830-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST STE 2E",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045749",
            "telephone_number": "423-430-9362",
            "fax_number": "423-830-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPLEBA",
        "first_name": "MADISON",
        "middle_name": "NICHOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "251S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.