NPIMap

Organization Active NPI

Columbia Medical Groupdaystar Inc

Doing business as Daystar Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Athens, TN
National Provider Identifier
1417960733
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COLUMBIA MEDICAL GROUPDAYSTAR INC
Doing business as
Daystar Counseling Center
Practice address
748 Tell Street
Athens, TN 37303
Phone
(423) 744-8734
Fax
(423) 649-0346
NPI assigned
Aug 15, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Elizabeth J Tullock, LCSWNPI 1881640712
Title
Director
Phone
(423) 744-8734

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X TN Primary

Addresses

Primary practice location

748 Tell Street
Athens, TN 37303

Mailing address

PO Box 867
Athens, TN 37371-0867
Phone (423) 744-8734

Other names 1

  • Daystar Counseling Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1417960733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373710867",
            "telephone_number": "423-744-8734",
            "fax_number": "423-649-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 TELL STREET",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "37303",
            "telephone_number": "423-744-8734",
            "fax_number": "423-649-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEDICAL GROUPDAYSTAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "TULLOCK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "423-744-8734",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daystar Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.