NPIMap

Organization Active NPI

Itavia'S House of Care LLC

  • In Home Supportive Care Agency
  • Smyrna, TN
National Provider Identifier
1083284814
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ITAVIA'S HOUSE OF CARE LLC
Practice address
10543 Cedar Grove Rd Ste 150
Smyrna, TN 37167-6525
Phone
(615) 905-6321
NPI assigned
Jun 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Authorized official

Name
Dr. Alicia Michelle Ellis, LPC-MHSP,NPI 1346677077
Title
Owner/Ceo
Phone
(615) 905-6321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

10543 Cedar Grove Rd Ste 150
Smyrna, TN 37167-6525

Mailing address

10543 Cedar Grove Rd Ste 150
Smyrna, TN 37167-6525
Phone (615) 905-6321

Other identifiers 1

IdentifierTypeStateIssuer
Q034586MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dralicia@therapyemail.com Direct

National Provider Directory

National Provider Directory

Locations

10543 Cedar Grove Rd
Ste 150
Smyrna, TN 37167
Phone (615) 905-6321

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1083284814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10543 CEDAR GROVE RD STE 150",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676525",
            "telephone_number": "615-905-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10543 CEDAR GROVE RD STE 150",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676525",
            "telephone_number": "615-905-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITAVIA'S HOUSE OF CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2022-06-10",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "615-905-6321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC-MHSP,"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q034586",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dralicia@therapyemail.com",
            "affiliation": "N",
            "endpointDescription": "Hipaa compliant email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10543 Cedar Grove Rd Ste 150",
            "city": "Smyrna",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371676525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.