Individual provider Active NPI

Chad Kingery, LCPC, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Athens, TN
National Provider Identifier
1457771230
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1718 Issued in TN
Practice address
2336 Congress Pkwy S
Athens, TN 37303-2820
Phone
(423) 266-6751
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1718 TN
Addiction (Substance Use Disorder) Counselor 101YA0400X LAC-LIC-3401 MT
Mental Health Counselor 101YM0800X BBH-PCLC-LIC-25856 MT
Addiction (Substance Use Disorder) Counselor 101YA0400X 1718 TN Primary

Addresses

Primary practice location

2336 Congress Pkwy S
Athens, TN 37303-2820

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747
Phone (865) 637-9711

Other practice location 1

285 2nd ave WN
Kalispell, MT 59901-3095
Phone (406) 890-2570

Other practice location 2

307 1st Ave E Ste 214
Kalispell, MT 59901-4978
Phone (406) 697-7912

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
LAC-LIC-3401MTMDAddiction (Substance Use Disorder) Counselor
BBH-PCLC-LIC-25856MTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Nov 24, 2024 Accepting new patients
Alpenglow Clinic LLC PastSince Sep 29, 2019 Accepting new patients
Mindful Connections Counseling LLC Addiction (Substance Use Disorder) Past Accepting new patients

Locations

2336 Congress Pkwy S
Athens, TN 37303
Phone (423) 507-0887

200 Tech Center Dr
Knoxville, TN 37912
Phone (865) 329-9124

Organizations & group practices 3

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1457771230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 CONGRESS PKWY S",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373032820",
            "telephone_number": "423-266-6751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 2nd ave WN",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013095",
            "country_code": "US",
            "telephone_number": "406-890-2570",
            "fax_number": "406-314-6186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "307 1st Ave E Ste 214",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599014978",
            "country_code": "US",
            "telephone_number": "406-697-7912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINGERY",
        "first_name": "CHAD",
        "credential": "LCPC, LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "1718",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "LAC-LIC-3401",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-PCLC-LIC-25856",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 22, 2024; 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.