Gina F Bottom, MMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1836 Issued in TN

Practice address

7015 Concord Rd
Brentwood, TN 37027-6606

Phone

(615) 625-2058

NPI assigned

Jan 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1154912517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N HUME AVE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662916",
            "telephone_number": "580-695-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 CONCORD RD",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370276606",
            "telephone_number": "615-625-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTOM",
        "first_name": "GINA",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "MMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "1836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gina@missionroadcounseling.com",
            "affiliation": "Y",
            "endpointDescription": "gina@missionroadcounseling.com",
            "affiliationName": "Fellowship Bible Church",
            "address_1": "7015 Concord Rd",
            "city": "Brentwood",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370276606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Border, DDS
• Greg Born
• Robert Borruso
• Bryan D. Borsum, D.C.
• Haley Boswell
• Courtney Elizabeth Bottoms Gustafson, M.ED
• Eric Bottoms
• Aaron Boudreaux
• Danielle Catherine Bourque
• Jade Liegh Bowers

• Mental Health Counselor in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.