Individual provider Active NPI

Raven Michelle Jaimes, LMSW

  • Mental Health Counselor
  • Clarksville, TN
National Provider Identifier
1467314724
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
15629 Issued in TN
Practice address
1860 Wilma Rudolph Blvd Ste 109
Clarksville, TN 37040-6750
Phone
(931) 208-2076
Fax
(931) 208-2054
NPI assigned
Nov 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 15629 TN Primary

Addresses

Primary practice location

1860 Wilma Rudolph Blvd Ste 109
Clarksville, TN 37040-6750

Mailing address

1860 Wilma Rudolph Blvd Ste 109
Clarksville, TN 37040-6750
Phone (931) 208-2076

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
15629TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Resilience Center CurrentSince Dec 7, 2025 Accepting new patients

Locations

1860 Wilma Rudolph Blvd
Ste 109
Clarksville, TN 37040
Phone (931) 208-2076

Organizations & group practices 1

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": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1467314724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 WILMA RUDOLPH BLVD STE 109",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406750",
            "telephone_number": "931-208-2076",
            "fax_number": "931-208-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 WILMA RUDOLPH BLVD STE 109",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406750",
            "telephone_number": "931-208-2076",
            "fax_number": "931-208-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMES",
        "first_name": "RAVEN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "15629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.