Active NPI
Whitney Ann Coulombe, LCSW
- Clinical Social Worker
- Memphis, TN
National Provider Identifier
1508005554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4930
- Practice address
- 4066 Summer Ave
Memphis, TN 38122-5225 - Phone
- (901) 531-1938
- NPI assigned
- Feb 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4930 | TN | Primary |
Addresses
Primary practice location
4066 Summer Ave
Memphis, TN 38122-5225
Mailing address
4066 Summer Ave
Memphis, TN 38122-5225
Phone (901) 531-1938
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4930 | Other | TN | LCSW LICENSE NUMBER |
Other names 1
- Whitney Ann Johnson
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4930 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
1310 E Main St
Chattanooga, TN 37404
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
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": "1234742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234742400000",
"number": "1508005554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4066 SUMMER AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381225225",
"telephone_number": "901-531-1938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4066 SUMMER AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381225225",
"telephone_number": "901-531-1938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COULOMBE",
"first_name": "WHITNEY",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-16",
"last_updated": "2009-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "4930",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW LICENSE NUMBER",
"identifier": "4930",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WHITNEY",
"last_name": "JOHNSON",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.