Individual provider Active NPI

Jasmine Brieann Bevens, LPC/MHSP

  • Mental Health Counselor
  • Kingsport, TN
National Provider Identifier
1104629344
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7810 Issued in TN
Practice address
1536 Bridgewater LN Ste 103
Kingsport, TN 37660-4103
Phone
(423) 343-5665
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 7810 TN Primary

Addresses

Primary practice location

1536 Bridgewater LN Ste 103
Kingsport, TN 37660-4103

Mailing address

975 Big Hill Rd
Mooresburg, TN 37811-5314
Phone (423) 231-4161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7810TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1104629344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 BIG HILL RD",
            "city": "MOORESBURG",
            "state": "TN",
            "postal_code": "378115314",
            "telephone_number": "423-231-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 BRIDGEWATER LN STE 103",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604103",
            "telephone_number": "423-343-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVENS",
        "first_name": "JASMINE",
        "middle_name": "BRIEANN",
        "credential": "LPC/MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "7810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.