Individual provider Active NPI

Corrie L Crook, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1508823899
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
28467 Issued in SC
Practice address
243 Dover Rd
Clarksville, TN 37042-4155
Phone
(931) 905-4646
NPI assigned
Apr 28, 2006
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024166934 VA
Family Nurse Practitioner 363LF0000X 18084 TN
Primary Care Nurse Practitioner 363LP2300X 3008191 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 28467 SC Primary

Addresses

Primary practice location

243 Dover Rd
Clarksville, TN 37042-4155

Mailing address

304 Bentwood LN
Columbia, SC 29229-8980
Phone (757) 870-1008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241024000212 SC Practitioner - Nurse Practitioner 7214927722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

115 Atrium Way
Suite 221
Columbia, SC 29223-6383
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28467SCMDPharmacy Technician
3008191KYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC CurrentSince Aug 20, 2024 Accepting new patients
Bradford Regional Medical Services Past Accepting new patients
Olean General Hospital Past Accepting new patients
Myrtle Beach Counseling Center PastSince Aug 6, 2019 Accepting new patients

Locations

115 Atrium Way
Ste 221
Columbia, SC 29223
Phone (803) 699-8887

3600 Forest Dr
Ste 302
Columbia, SC 29204
Phone (803) 699-8887

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.corriecrook@149035.advancedmd-direct.com

Organizations & group practices 4

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1508823899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 BENTWOOD LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298980",
            "telephone_number": "757-870-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370424155",
            "telephone_number": "931-905-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOK",
        "first_name": "CORRIE",
        "middle_name": "L",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024166934",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18084",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3008191",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "28467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.