Individual provider Active NPI

Megan Michellie Marcus, LCSW

  • Clinical Social Worker
  • Maryville, TN
National Provider Identifier
1356586754
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000004928 Issued in TN
Practice address
1017 Hampshire Dr
Maryville, TN 37801-3525
Phone
(865) 384-4079
Fax
(865) 351-1472
NPI assigned
Dec 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW0000004928 TN Primary

Addresses

Primary practice location

1017 Hampshire Dr
Maryville, TN 37801-3525

Mailing address

576 Foothills PLZ # 196
Maryville, TN 37801-2305
Phone (865) 384-4079

Other practice location 1

5410 Homberg Dr Ste 14
Knoxville, TN 37919-5029
Phone (865) 588-3173

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090128000588 TN Practitioner - Clinical Social Worker 6305900838 Practice locations: Maryville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1017 Hampshire Dr
Maryville, TN 37801-3525
Phone (865) 384-4079

576 Foothills PLZ
Maryville, TN 37801-2305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW0000004928TNMDClinical Social Worker
4928TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Mind Counseling Services, Inc Clinical PastSince Jul 28, 2012 Accepting new patients
Mending Hearts & Minds, PLLC PastSince Jul 24, 2022 Accepting new patients
Prisma Health - Blount Memorial Hospital Inc. Past Accepting new patients

Organizations & group practices 3

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": "1229212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1356586754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 FOOTHILLS PLZ # 196",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378012305",
            "telephone_number": "865-384-4079",
            "fax_number": "865-351-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 HAMPSHIRE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378013525",
            "telephone_number": "865-384-4079",
            "fax_number": "865-351-1472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5410 Homberg Dr Ste 14",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379195029",
            "country_code": "US",
            "telephone_number": "865-588-3173",
            "fax_number": "865-588-3174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "MEGAN",
        "middle_name": "MICHELLIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-14",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.