Individual provider Active NPI

Starlett Renee Armstrong, LCSW

  • Clinical Social Worker
  • Jackson, TN
National Provider Identifier
1487849931
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7161 Issued in TN
Practice address
24 Kirbywood CV
Jackson, TN 38305-1801
Phone
(731) 444-1344
NPI assigned
Sep 7, 2007
Last updated
Sep 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7161 TN Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

24 Kirbywood CV
Jackson, TN 38305-1801

Mailing address

24 Kirbywood CV
Jackson, TN 38305-1801
Phone (731) 444-1344

Other identifiers 1

IdentifierTypeStateIssuer
Q074863MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606002353 TN Practitioner - Clinical Social Worker 2163889114 Reassigns benefits to 2 organizations
Practice locations: Jackson, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

400 Balsam Dr
Knoxville, TN 37918-3001
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7161TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Behavioral Health Services CurrentSince May 27, 2024 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients
Five Star Counseling Clinical CurrentSince Mar 16, 2023 Accepting new patients

Locations

793 Tennessee St
Bolivar, TN 38008
Phone (731) 228-9068

26 Lamar Cir
Ste 3
Jackson, TN 38305
Phone (731) 337-5091

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1487849931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 KIRBYWOOD CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051801",
            "telephone_number": "731-444-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 KIRBYWOOD CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051801",
            "telephone_number": "731-444-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "STARLETT",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7161",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q074863",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.