Individual provider Active NPI

Carlye Carpenter Hutchinson

  • Professional Counselor
  • Collierville, TN
National Provider Identifier
1366987703
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1953 Issued in MS
Practice address
165 N Main St
Suite 204
Collierville, TN 38017-2656
Phone
(901) 286-4017
Fax
(901) 861-5516
NPI assigned
Dec 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1953 MS Primary

Addresses

Primary practice location

165 N Main St
Suite 204
Collierville, TN 38017-2656

Mailing address

1414 Milestone Cir
Collierville, TN 38017-6888
Phone (662) 255-3568

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

State licenses

LicenseStateTypeSpecialty
1953MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Center, PLLC Professional CurrentSince Aug 14, 2022 Accepting new patients

Locations

140 S Main St
Ste 28
Collierville, TN 38017
Phone (504) 231-7722

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": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1366987703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 MILESTONE CIR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380176888",
            "telephone_number": "662-255-3568",
            "fax_number": "901-861-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N MAIN ST",
            "address_2": "SUITE 204",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172656",
            "telephone_number": "901-286-4017",
            "fax_number": "901-861-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "CARLYE",
        "middle_name": "CARPENTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.