Individual provider Active NPI

Julie Gardenhire, LMFT

  • Marriage & Family Therapist
  • Cleveland, TN
National Provider Identifier
1699323782
Registry record updated Aug 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1397 Issued in TN
Practice address
3555 Keith St NW Ste 104
Cleveland, TN 37312-4375
Phone
(423) 310-8201
Fax
(888) 858-1871
NPI assigned
Aug 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1397 TN Primary

Addresses

Primary practice location

3555 Keith St NW Ste 104
Cleveland, TN 37312-4375

Mailing address

3555 Keith St NW Ste 104
Cleveland, TN 37312-4375
Phone (423) 310-8201

Other practice location 1

3085 Broad St Ste A
Chattanooga, TN 37408-3089
Phone (423) 310-8206 ext. 1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426000798 TN Practitioner - Marriage and Family Therapist 1153761937 Practice locations: Cleveland, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1397TNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1567209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567209600000",
    "number": "1699323782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KEITH ST NW STE 104",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124375",
            "telephone_number": "423-310-8201",
            "fax_number": "888-858-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KEITH ST NW STE 104",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124375",
            "telephone_number": "423-310-8201",
            "fax_number": "888-858-1871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3085 Broad St Ste A",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374083089",
            "country_code": "US",
            "telephone_number": "423-310-8206 x1",
            "fax_number": "888-858-1871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDENHIRE",
        "first_name": "JULIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-31",
        "last_updated": "2019-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "1397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.