Active NPI
Chandra McMullen
- Marriage & Family Therapist
- Kingston, TN
National Provider Identifier
1124296900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMT0000000704
- Practice address
- 183 Fiddlers LN
Kingston, TN 37763-4020 - Phone
- (865) 376-2296
- Fax
- (865) 376-0369
- NPI assigned
- Feb 14, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMT0000000704 | TN | Primary |
Addresses
Primary practice location
183 Fiddlers LN
Kingston, TN 37763-4020
Mailing address
110 Lakewood LN
Harriman, TN 37748-5437
Phone (865) 376-2296
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMT0000000704 | TN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sequel Schools LLC Dba Kingston Academy | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychiatric Residential Treatment Facility
- Kingston, TN
- NPI 1245398908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202947200000",
"number": "1124296900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 LAKEWOOD LN",
"city": "HARRIMAN",
"state": "TN",
"postal_code": "377485437",
"telephone_number": "865-376-2296",
"fax_number": "865-376-0369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 FIDDLERS LN",
"city": "KINGSTON",
"state": "TN",
"postal_code": "377634020",
"telephone_number": "865-376-2296",
"fax_number": "865-376-0369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLEN",
"first_name": "CHANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-14",
"last_updated": "2008-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "LMT0000000704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.