Patrisha Faye Tatum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8035 Issued in TN

Practice address

1360 Mackey Branch Dr
Chattanooga, TN 37421-3225

Phone

(423) 443-3336

NPI assigned

Sep 28, 2020

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agape Youth Behavioral HealthGroup PAC ID 1254731417, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Agape Youth Behavioral Health

  • Child & Adolescent Psychiatry Physician
  • Chattanooga, TN
  • NPI 1528405925
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1740897495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N PETERS RD STE C",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379227509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 MACKEY BRANCH DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213225",
            "telephone_number": "423-443-3336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 N Peters Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379227509",
            "country_code": "US",
            "telephone_number": "865-290-2278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "PATRISHA",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "11208",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "8035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tartesos PLLC
• Audra Marlana Tate Kennedy, LPC
• Le'Darius Shakir Tate
• Sidney Rhiannon Tate
• Nikki Reynolds Tatum, LCSW
• Rachel Anna Taubenheim, PSY.D..
• Yankarlos Taveras, BCBA
• Kevin Andrew Tawzer, PA-C
• April L Taylor, LPC
• Ashley Brooke Taylor

• Clinical Social Worker in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.