Active NPI
Calm Place
- Clinical Social Worker
- Jackson, TN
National Provider Identifier
1407500655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- CALM PLACE
- Practice address
- 170 Smithfield Dr
Jackson, TN 38305-1817 - Phone
- (731) 300-1117
- Fax
- (731) 265-6028
- NPI assigned
- Feb 7, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Lovelace, CREDENTIALING
- Title
- Credentialing
- Phone
- (731) 410-7719
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
170 Smithfield Dr
Jackson, TN 38305-1817
Mailing address
170 Smithfield Dr
Jackson, TN 38305-1817
Phone (731) 300-1117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q037696 | Medicaid | TN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644192000000",
"number": "1407500655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 SMITHFIELD DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383051817",
"telephone_number": "731-300-1117",
"fax_number": "731-265-6028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 SMITHFIELD DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383051817",
"telephone_number": "731-300-1117",
"fax_number": "731-265-6028"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CALM PLACE",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-07",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A",
"authorized_official_last_name": "LOVELACE",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "731-410-7719",
"authorized_official_credential": "CREDENTIALING"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q037696",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.