Jeremiah Scott Barker, MA, LPC-MHSP
Individual provider Active NPI Mental Health Counselor · Cleveland, TN
NPI 1366815441 · NPPES record last updated Jan 9, 2024
Key facts
- NPI
- 1366815441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 4160 Ocoee St N
Cleveland, TN 37312-4885 - Phone
- (888) 291-4357
- NPI assigned
- Nov 11, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240116001032 | TN | Practitioner - Other (Non-Physician) | 5799137717 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5632 | TN | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | TN | Yes |
Addresses
Primary practice location
4160 Ocoee St N
Cleveland, TN 37312-4885
Mailing address
4160 Ocoee St N
Cleveland, TN 37312-4885
Phone (888) 291-4357
Other providers in Cleveland, TN
- Casey Taiona Banner
- Banyan Family Night Clinic, LLC
- Adam Gregory Barfoot
- Victoria Hope Barham
- Daniel Barker
- Kevin D Barna
- Ryan Thomas Barnes
- Brent A Barrow
- Brenda Darlene Barton
- Kristie Lynette Barton
All providers in Cleveland, TN · Mental Health Counselor in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.