Active NPI
Damien Eric Nethery, LCSW
- Clinical Social Worker
- Ripley, TN
National Provider Identifier
1689615320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4585
- Practice address
- 79 Highway 51 S
Ripley, TN 38063-4580 - Phone
- (731) 635-8189
- Fax
- (731) 635-8121
- NPI assigned
- Jun 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4585 | TN | Primary |
Addresses
Primary practice location
79 Highway 51 S
Ripley, TN 38063-4580
Mailing address
79 Highway 51 S
Ripley, TN 38063-4580
Phone (731) 635-8189
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4585 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1689615320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 HIGHWAY 51 S",
"city": "RIPLEY",
"state": "TN",
"postal_code": "380634580",
"telephone_number": "731-635-8189",
"fax_number": "731-635-8121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 HIGHWAY 51 S",
"city": "RIPLEY",
"state": "TN",
"postal_code": "380634580",
"telephone_number": "731-635-8189",
"fax_number": "731-635-8121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETHERY",
"first_name": "DAMIEN",
"middle_name": "ERIC",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "4585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ripley, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.