Jacqueline Mae Odell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000003919 Issued in TN

Practice address

6110 Shallowford Rd
Chattanooga, TN 37421

Phone

(800) 632-6074

Fax

(866) 341-7509

NPI assigned

Sep 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  TN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1306943865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10414",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33773",
            "telephone_number": "800-632-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "800-632-6074",
            "fax_number": "866-341-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "JACQUELINE",
        "middle_name": "MAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000003919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3926147",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Occupational Alternative and Rehabilitative Services, PC
• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest P.a.
• Adriana Oceguera
• Alan Clifton Odom, M.D.
• Josephine Pauline Odom, CERTIFIED HAIR LOSS
• Ruby Amelia Odum, PHARMD
• Patrick Oellerich, MFTI
• William F Oellerich, MD

• Clinical Social Worker in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.