Individual provider Active NPI

Adina H Gilliam, LMFT

  • Marriage & Family Therapist
  • Franklin, TN
National Provider Identifier
1568526762
Registry record updated Dec 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMT0000000911 Issued in TN
Practice address
109 Holiday CT
Suite A2
Franklin, TN 37067-3000
Phone
(828) 230-8353
Fax
(973) 916-1998
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1144 NC
Marriage & Family Therapist 106H00000X LMT0000000911 TN Primary

Addresses

Primary practice location

109 Holiday CT
Suite A2
Franklin, TN 37067-3000

Mailing address

527 Bancroft Way
Franklin, TN 37064-2171
Phone (828) 230-8353

Other identifiers 2

IdentifierTypeStateIssuer
11741525OtherCAQH
6105150MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMT0000000911TNMDMarriage & Family Therapist
1144NCMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385856000000",
    "number": "1568526762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 BANCROFT WAY",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370642171",
            "telephone_number": "828-230-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HOLIDAY CT",
            "address_2": "SUITE A2",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673000",
            "telephone_number": "828-230-8353",
            "fax_number": "973-916-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "ADINA",
        "middle_name": "H",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1144",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "LMT0000000911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11741525",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6105150",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2013; 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.