NPIMap

Organization Active NPI

Pandoras Awakening

  • Clinical Social Worker
  • Madison, TN
National Provider Identifier
1114583770
Registry record updated May 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PANDORAS AWAKENING
Practice address
223 Madison St Ste 102
Madison, TN 37115-3660
Phone
(615) 375-6896
NPI assigned
May 18, 2019
Last updated
May 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2019

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

Authorized official

Name
Renee D Burwell, LCSW, MPA, CSTNPI 1639337975
Title
Ceo
Phone
(615) 375-6896

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU Primary
Marriage & Family Therapist 106H00000X NU
Psychiatric/Mental Health Registered Nurse 163WP0808X NU

Addresses

Primary practice location

223 Madison St Ste 102
Madison, TN 37115-3660

Mailing address

223 Madison St Ste 102
Madison, TN 37115-3660
Phone (615) 375-6896

National Provider Directory

National Provider Directory

Locations

223 Madison St
Ste 102
Madison, TN 37115
Phone (615) 375-6896

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1558137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558137600000",
    "number": "1114583770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MADISON ST STE 102",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371153660",
            "telephone_number": "615-375-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 MADISON ST STE 102",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371153660",
            "telephone_number": "615-375-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANDORAS AWAKENING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-18",
        "last_updated": "2019-05-18",
        "status": "A",
        "authorized_official_last_name": "BURWELL",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-375-6896",
        "authorized_official_credential": "LCSW, MPA, CST"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2019; 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.