Individual provider Active NPI

Peggy G Sandidge, MED LPC MHSP

  • Mental Health Counselor
  • Cleveland, TN
National Provider Identifier
1316908262
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1442 Issued in TN
Practice address
2765 Executive PK Dr NW
Suite 1
Cleveland, TN 37312
Phone
(423) 559-8989
Fax
(423) 559-8989
NPI assigned
Mar 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1442 TN Primary

Addresses

Primary practice location

2765 Executive PK Dr NW
Suite 1
Cleveland, TN 37312

Mailing address

2765 Executive PK Dr NW
Suite 1
Cleveland, TN 37312
Phone (423) 559-8989

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
Master of Education

State licenses

LicenseStateTypeSpecialty
1442TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sarath B Gangavarapu MD PC Past Accepting new patients

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316908262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 EXECUTIVE PK DR NW",
            "address_2": "SUITE 1",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-559-8989",
            "fax_number": "423-559-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 EXECUTIVE PK DR NW",
            "address_2": "SUITE 1",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-559-8989",
            "fax_number": "423-559-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIDGE",
        "first_name": "PEGGY",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "MED LPC MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "1442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.