NPIMap

Organization Active NPI

Lifeline Counseling Center PLLC

  • Professional Counselor
  • Maryville, TN
National Provider Identifier
1508168188
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LIFELINE COUNSELING CENTER PLLC
Practice address
294 Gamble Ave
Maryville, TN 37801-4943
Phone
(865) 981-7400
Fax
(865) 977-5400
NPI assigned
Dec 2, 2010
Last updated
Dec 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

Name
Brenda-Lee W. Duarte, LPC-MHSPNPI 1982637583
Title
Executive Director
Phone
(865) 981-7400

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

294 Gamble Ave
Maryville, TN 37801-4943

Mailing address

294 Gamble Ave
Maryville, TN 37801-4943
Phone (865) 981-7400

Other names 1

  • LifeLine Counseling Center Other name

National Provider Directory

National Provider Directory

Locations

1033 W Broadway Ave
Maryville, TN 37801
Phone (865) 981-7400

294 Gamble Ave
Maryville, TN 37801
Phone (865) 977-9128

Practitioners & affiliated clinicians

Practitioners 5

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": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1508168188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 GAMBLE AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014943",
            "telephone_number": "865-981-7400",
            "fax_number": "865-977-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 GAMBLE AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014943",
            "telephone_number": "865-981-7400",
            "fax_number": "865-977-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE COUNSELING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "BRENDA-LEE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "865-981-7400",
        "authorized_official_credential": "LPC-MHSP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeLine Counseling Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.