Organization Active NPI

Kismet Counseling Services, PLLC

Doing business as Kismet Counseling Services

  • Mental Health Counselor
  • Clarksville, TN
National Provider Identifier
1578347886
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KISMET COUNSELING SERVICES, PLLC
Doing business as
Kismet Counseling Services
Practice address
2523 Wilma Rudolph Blvd
Clarksville, TN 37040-5844
Phone
(931) 444-8355
Fax
(931) 443-9587
NPI assigned
Aug 21, 2023
Last updated
Dec 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Authorized official

Name
Tameka McCullough, LPC-MHSPNPI 1154049187
Title
Owner/Counselor
Phone
(931) 444-8355

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
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2523 Wilma Rudolph Blvd
Clarksville, TN 37040-5844

Mailing address

1565 Cedar Springs Cir
Clarksville, TN 37042-1579
Phone (931) 241-9227

Other names 1

  • Kismet Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250213003109 TN Part B Supplier - Clinic/Group Practice 3173053634 Receives reassigned benefits from 1 practitioner
Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

2523 Wilma Rudolph Blvd
Clarksville, TN 37040
Phone (724) 734-3571

Practitioners & affiliated clinicians

Practitioners 1

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": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735344000000",
    "number": "1578347886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 CEDAR SPRINGS CIR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370421579",
            "telephone_number": "931-241-9227",
            "fax_number": "931-443-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 WILMA RUDOLPH BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405844",
            "telephone_number": "931-444-8355",
            "fax_number": "931-443-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISMET COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "TAMEKA",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "931-444-8355",
        "authorized_official_credential": "LPC-MHSP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kismet Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.