Ethel M Vicks

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

ETHEL M VICKS

Doing business as

Make A Way For Adults

Practice address

162 Claire PL
Talbott, TN 37877-1704

Phone

(423) 353-0322

NPI assigned

Aug 4, 2023

Last updated

Aug 4, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ethel M Vicks

Title

Ceo

Phone

(423) 353-0322

Specialties & licenses 2

Addresses

Other names 1

• Make A Way For Adults Doing business as

Practitioners 1

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.

• Ethel M Glenn, , MS, LMFT

  • Marriage & Family Therapist
  • Talbott, TN
  • NPI 1154931509

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1457033805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 CLAIRE PL",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378771704",
            "telephone_number": "423-353-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 CLAIRE PL",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378771704",
            "telephone_number": "423-353-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEL M VICKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "VICKS",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-353-0322"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Make A Way For Adults",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Jewell Eldridge, LPN
• Oren Michael Ellis, LPE
• Sasha Mecole Ellison, CNA
• Meredith Leigh Embree, BA
• Arlin Yasmin Escalante
• Sharon Farge, PSYD
• Stefani Aracelly Fonseca-Jacamo
• Carol Allin Fullerr, R.N.
• Christopher Edward Gehrke
• Ethel M Glenn, , MS, LMFT

• Addiction (Substance Use Disorder) Counselor in Talbott, TN
• Providers in Talbott, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.