Individual provider Active NPI

Melanie Dewerff, LPC/MHSP

  • Professional Counselor
  • Bartlett, TN
National Provider Identifier
1235795188
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4579 Issued in TN
Practice address
2868 Summer Oaks Dr Ste 103
Bartlett, TN 38134-2818
Phone
(931) 216-1788
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4579 TN
Mental Health Counselor 101YM0800X 13382 MA
Professional Counselor 101YP2500X LPCC12065 CA
Professional Counselor 101YP2500X CP5191-R NV
Professional Counselor 101YP2500X 0701012041 VA
Professional Counselor 101YP2500X 13382 MA
Professional Counselor 101YP2500X 4579 TN Primary

Addresses

Primary practice location

2868 Summer Oaks Dr Ste 103
Bartlett, TN 38134-2818

Mailing address

1961 Carr Ave # 1
Memphis, TN 38104-5258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4579TNMDMental Health Counselor
LPCC12065CAMDProfessional Counselor
13382MAMDProfessional Counselor
CP5191-RNVMDProfessional Counselor
0701012041VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince Feb 13, 2024 Accepting new patients

Locations

90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889

999 Waterside Dr
Ste 2525
Norfolk, VA 23510
Phone (757) 777-3787

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.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1235795188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1961 CARR AVE # 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2868 SUMMER OAKS DR STE 103",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342818",
            "telephone_number": "931-216-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWERFF",
        "first_name": "MELANIE",
        "credential": "LPC/MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4579",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "13382",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC12065",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CP5191-R",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701012041",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MA",
            "license": "13382",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.