A Prodigal'S Path 2 Recovery, Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

A PRODIGAL'S PATH 2 RECOVERY, INC.

Practice address

107 Paint Rock Ferry Rd
Kingston, TN 37763-2921

Phone

(865) 730-6628

Fax

(865) 730-6792

NPI assigned

May 22, 2020

Organization subpart

No

Name

Dr. Charles Loyd Stallings, LADAC II, MAC

Title

Program Manager

Phone

(865) 730-6628

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 22, 2020.

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1386267490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PAINT ROCK FERRY RD",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632921",
            "telephone_number": "865-730-6628",
            "fax_number": "865-730-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PAINT ROCK FERRY RD",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632921",
            "telephone_number": "865-730-6628",
            "fax_number": "865-730-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A PRODIGAL'S PATH 2 RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "STALLINGS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "LOYD",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "865-730-6628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LADAC II, MAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prodigalspath@comcast.net",
            "affiliation": "N",
            "endpointDescription": "prodigalspath@comcast.net",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Permissable Client information",
            "address_1": "107 Paint Rock Ferry Rd",
            "city": "Kingston",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377632921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Active Family & Sports Chiropractic PLLC
• Taylor Adkins, PTA
• Agilitas USA, Inc
• Robert Keith Albiston, PHD
• Martine Gabrielle Alger, DPT

• All providers in Kingston, TN
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.