Juanita Louise Chism Doss, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000004313 Issued in TN

Practice address

6011 Shallowford Rd
Chattanooga, TN 37421

Phone

(800) 632-6074

Fax

(866) 341-7509

NPI assigned

Sep 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Juanita Louise Bernard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/careycounselingcenter/r4/

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

• Carey Counseling Center, Inc.

  • Mental Health Counselor
  • Paris, TN
  • NPI 1760568877
  NPD (past)

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1114024692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 STONE RIDGE CV",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383558922",
            "telephone_number": "731-499-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "800-632-6074",
            "fax_number": "866-341-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISM DOSS",
        "first_name": "JUANITA",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4313",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3927330",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUANITA",
            "last_name": "BERNARD",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Edward Childress, DNP
• Roger William Childress, DDS, MD
• Kent D Childs, MD
• Chiropractic Arts, LLC
• Caitlin Wade Chisholm, BA
• Cho Wound Care Physicians PLLC
• Stephen Dohnghee Cho, MD
• Tom Cho, DDS
• Hazuki Choe
• Anna Eileen Choi, CRNP

• Clinical Social Worker in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.