NPIMap

Organization Active NPI

Clover Mental Health LLC

  • Counseling Psychologist
  • Lebanon, TN
National Provider Identifier
1457971087
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
CLOVER MENTAL HEALTH LLC
Practice address
135 Quita Cir Apt B
Lebanon, TN 37087-4440
Phone
(615) 955-1729
NPI assigned
Apr 23, 2020
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Justin H DonnellyNPI 1861853657
Title
Ceo/Owner
Phone
(615) 955-1729

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X Primary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

135 Quita Cir Apt B
Lebanon, TN 37087-4440

Mailing address

135 Quita Cir Apt B
Lebanon, TN 37087-4440
Phone (615) 955-1729

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1457971087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 QUITA CIR APT B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874440",
            "telephone_number": "615-955-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 QUITA CIR APT B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874440",
            "telephone_number": "615-955-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-09-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "615-955-1729"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.