Individual provider Active NPI

Michelle C Demarsilis, LCSW

  • Professional Counselor
  • Clarksville, TN
National Provider Identifier
1598784852
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3696 Issued in TN
Practice address
3524 Spring House TRL
Clarksville, TN 37040-6238
Phone
(615) 651-1596
NPI assigned
Jul 18, 2006
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3696 TN Primary

Addresses

Primary practice location

3524 Spring House TRL
Clarksville, TN 37040-6238

Mailing address

3524 Spring House TRL
Clarksville, TN 37040-6238
Phone (615) 651-1596

Other practice location 1

25 Lindsley Ave
Nashville, TN 37210-2038
Phone (615) 259-9055 ext. 532

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3696TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
Sexual Assault Center PastSince Aug 12, 2013 Accepting new patients
Recovery Clinic Group Tennessee Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michelledemarsilis@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1598784852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 SPRING HOUSE TRL",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406238",
            "telephone_number": "615-651-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 SPRING HOUSE TRL",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406238",
            "telephone_number": "615-651-1596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Lindsley Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372102038",
            "country_code": "US",
            "telephone_number": "615-259-9055 x532",
            "fax_number": "615-259-9056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMARSILIS",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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, 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.