NPIMap

Organization Active NPI

Riverside Psychotherapy, PLLC

  • Professional Counselor
  • Chattanooga, TN
National Provider Identifier
1477987394
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2864 Issued in TN
Legal business name
RIVERSIDE PSYCHOTHERAPY, PLLC
Practice address
3914 Saint Elmo Ave Ste C
Chattanooga, TN 37409-1269
Phone
(423) 802-6943
Fax
(888) 508-6829
NPI assigned
Aug 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Ms. Laura Susan Sikes, MA, LPC-MHSPNPI 1669636742
Title
Office Manager/Therapist
Phone
(423) 802-6943

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 2864 TN Primary

Addresses

Primary practice location

3914 Saint Elmo Ave Ste C
Chattanooga, TN 37409-1269

Mailing address

3914 Saint Elmo Ave Ste C
Chattanooga, TN 37409-1269
Phone (423) 802-6943

Other practice location 1

633 Chestnut St
Suite 600 Republic Centre
Chattanooga, TN 37450-4000
Phone (423) 802-6943

Other identifiers 2

IdentifierTypeStateIssuer
12087518OtherTNCAQH PROVIDER ID
1669636742OtherTNNPI INDIVIDUAL NUMBER

National Provider Directory

National Provider Directory

Locations

3914 Saint Elmo Ave
Ste C
Chattanooga, TN 37409
Phone (423) 802-6943

633 Chestnut St
Ste 600
Chattanooga, TN 37450
Phone (423) 802-6943

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1477987394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 SAINT ELMO AVE STE C",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374091269",
            "telephone_number": "423-802-6943",
            "fax_number": "888-508-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 SAINT ELMO AVE STE C",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374091269",
            "telephone_number": "423-802-6943",
            "fax_number": "888-508-6829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "633 Chestnut St",
            "address_2": "Suite 600 Republic Centre",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374504000",
            "country_code": "US",
            "telephone_number": "423-802-6943",
            "fax_number": "423-266-6784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERSIDE PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-27",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "SIKES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER/THERAPIST",
        "authorized_official_telephone_number": "423-802-6943",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LPC-MHSP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "2864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "12087518",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1669636742",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.