Individual provider Active NPI

Angela Clifton-Stewart, LPC, PHD

  • Clinical Psychologist
  • Nashville, TN
National Provider Identifier
1134344641
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3679 Issued in TN
Practice address
110 29TH Ave N
Nashville, TN 37203-1401
Phone
(615) 822-8679
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC004598 GA
Clinical Psychologist 103TC0700X 3679 TN Primary

Addresses

Primary practice location

110 29TH Ave N
Nashville, TN 37203-1401

Mailing address

PO Box 952
Conley, GA 30288-0952
Phone (770) 595-2202

Other practice location 1

160 Clairemont Ave Ste 200
Decatur, GA 30030-2546
Phone (404) 791-2004

Other practice location 2

200 W Martin Luther King Blvd Ste 1000
Chattanooga, TN 37402-2571
Phone (404) 791-2004

Other identifiers 3

IdentifierTypeStateIssuer
3679OtherTNLICENSED PSYCHOLOGIST
863215023BMedicaidGA
Q070574MedicaidTN

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LPC004598GAMDProfessional Counselor
3679TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Angela C. Stewart, LPC, P.C. Professional Current Accepting new patients
Assertive Community Recovery, LLC PastSince Jul 19, 2017 Accepting new patients

Locations

2308 Perimeter Park Dr
Ste 100
Atlanta, GA 30341
Phone (770) 457-5577

160 Clairemont Ave
Ste 200
Decatur, GA 30030
Phone (678) 324-0264

200 W Martin Luther King Blvd
Ste 1000
Chattanooga, TN 37402
Phone (423) 269-2255

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1134344641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952",
            "city": "CONLEY",
            "state": "GA",
            "postal_code": "302880952",
            "telephone_number": "770-595-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031401",
            "telephone_number": "615-822-8679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Clairemont Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300302546",
            "country_code": "US",
            "telephone_number": "404-791-2004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Martin Luther King Blvd Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374022571",
            "country_code": "US",
            "telephone_number": "404-791-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLIFTON-STEWART",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "LPC, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004598",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "3679",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "863215023B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q070574",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.