Jennifer Canales

Individual provider Active NPI Professional Counselor · Nashville, TN

NPI 1174147243 · NPPES record last updated Aug 19, 2024

Key facts

NPI
1174147243
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
4623 Trousdale Dr
Nashville, TN 37204-4584
Phone
(615) 301-8431
NPI assigned
Jun 3, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLC (703 clinicians)

Practice addresses (Care Compare)

275 Robert Rose Dr
BLDG B
Murfreesboro, TN 37129-6347
Phone (888) 374-5066

5030 Carothers Pkwy
Suite 120
Franklin, TN 37067-6030
Phone (888) 374-5066

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240131002369 TN Practitioner - Other (Non-Physician) 3173976610 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6596TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Current
since Jan 1, 2024
Accepting new patients
Family Care Center, LLC Mental Health Current
since Jan 1, 2024
Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

5030 Carothers Pkwy
Ste 120
Franklin, TN 37067
Phone (615) 534-2176

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15315/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

4623 Trousdale Dr
Nashville, TN 37204-4584

Mailing address

688 Piccadilly Row
Antioch, TN 37013-1724
Phone (615) 495-3776

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL 615-301-8469

Other providers in Nashville, TN

All providers in Nashville, TN · Professional Counselor in Tennessee

Sources for this page

Verify at the official NPI Registry.