Organization Active NPI

Cleveland Counseling Associates, P.C.

  • Clinical Social Worker
  • Cleveland, TN
National Provider Identifier
1568411148
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CLEVELAND COUNSELING ASSOCIATES, P.C.
Practice address
2700 Westside Dr NW
Suite 309
Cleveland, TN 37312-3699
Phone
(423) 728-2282
Fax
(423) 728-2234
NPI assigned
May 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie Holt, LCSWNPI 1073518775
Title
Partner
Phone
(423) 728-2282

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
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2700 Westside Dr NW
Suite 309
Cleveland, TN 37312-3699

Mailing address

2700 Westside Dr NW
Suite 309
Cleveland, TN 37312-3699
Phone (423) 728-2282

Other identifiers 2

IdentifierTypeStateIssuer
0167914OtherTNBLUE CROSS BLUE SHIELD
3695661MedicaidTN

National Provider Directory

National Provider Directory

Locations

2700 Westside Dr NW
Ste 309
Cleveland, TN 37312
Phone (423) 559-8989

Practitioners & affiliated clinicians

Practitioners 2

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": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568411148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WESTSIDE DR NW",
            "address_2": "SUITE 309",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123699",
            "telephone_number": "423-728-2282",
            "fax_number": "423-728-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WESTSIDE DR NW",
            "address_2": "SUITE 309",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123699",
            "telephone_number": "423-728-2282",
            "fax_number": "423-728-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND COUNSELING ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "423-728-2282",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0167914",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3695661",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.