180 Red Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

180 RED INC

Practice address

93 Beaumont St
Clarksville, TN 37040-3217

Phone

(931) 274-7588

NPI assigned

Dec 9, 2024

Last updated

Dec 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Lynch, PH.D.

Title

Ceo

Phone

(615) 669-8372

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1679389100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 BEAUMONT ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 BEAUMONT ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403217",
            "telephone_number": "931-274-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "180 RED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-669-8372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.