Organization Active NPI

Hope Again Counseling and Court Mediation, LLC

  • Clinical Social Worker
  • Kingsport, TN
National Provider Identifier
1619110319
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000004305 Issued in TN
Legal business name
HOPE AGAIN COUNSELING AND COURT MEDIATION, LLC
Practice address
2005 Venture Park
Kingsport, TN 37660-1098
Phone
(423) 578-7878
Fax
(423) 578-6500
NPI assigned
Apr 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Mrs. Marsha G Rose, LCSWNPI 1689778672
Title
Chief Executive Officer (Co-Owner)
Phone
(423) 578-7878

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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LSW0000004305 TN Primary

Addresses

Primary practice location

2005 Venture Park
Kingsport, TN 37660-1098

Mailing address

2005 Venture Park
Kingsport, TN 37660-1098
Phone (423) 578-7878

Other identifiers 2

IdentifierTypeStateIssuer
39275311MedicaidTN
39246901MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090708000800 TN Part B Supplier - Clinic/Group Practice 3476605205 Receives reassigned benefits from 1 practitioner
Practice locations: Kingsport, TN

National Provider Directory

National Provider Directory

Locations

2005 Venture Park
Kingsport, TN 37660
Phone (423) 578-7208

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1619110319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 VENTURE PARK",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376601098",
            "telephone_number": "423-578-7878",
            "fax_number": "423-578-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 VENTURE PARK",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376601098",
            "telephone_number": "423-578-7878",
            "fax_number": "423-578-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE AGAIN COUNSELING AND COURT MEDIATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER (CO-OWNER)",
        "authorized_official_telephone_number": "423-578-7878",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39275311",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39246901",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.