Individual provider Active NPI

Chris Cain, PHD, LADAC 2, CCS

  • Addiction (Substance Use Disorder) Counselor
  • Riddleton, TN
National Provider Identifier
1750990487
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LADAC-1729 Issued in TN
Practice address
92 Beasley Bend Rd
Riddleton, TN 37047
Phone
(629) 666-1764
NPI assigned
Jul 29, 2020
Last updated
Oct 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LCAS-22476 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X LADAC-1729 TN Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCADC-287326 KY
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-22476 NC
Psychoanalyst 102L00000X LCAS-22476 NC

Addresses

Primary practice location

92 Beasley Bend Rd
Riddleton, TN 37047

Mailing address

92 Beasley Bend Rd
Riddleton, TN 37047
Phone (629) 666-1764

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL www.ajaya.org
CONNECT URL www.colorfeast.org
CONNECT URL www.colorfeast.org Ajaya

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCADC-287326KYMDAddiction (Substance Use Disorder) Counselor
LADAC-1729TNMDAddiction (Substance Use Disorder) Counselor
LCAS-22476NCMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1750990487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 BEASLEY BEND RD",
            "city": "RIDDLETON",
            "state": "TN",
            "postal_code": "37047",
            "telephone_number": "629-666-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BEASLEY BEND RD",
            "city": "RIDDLETON",
            "state": "TN",
            "postal_code": "37047",
            "telephone_number": "629-666-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "PHD, LADAC 2, CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "LCAS-22476",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LADAC-1729",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "LCADC-287326",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-22476",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NC",
            "license": "LCAS-22476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.ajaya.org",
            "affiliation": "Y",
            "address_1": "4010 Littlejohn Church Rd",
            "city": "Lenoir",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286458563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.colorfeast.org",
            "affiliation": "N",
            "address_1": "92 Beasley Bend Rd",
            "city": "Riddleton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.colorfeast.org",
            "affiliation": "Y",
            "endpointDescription": "DBA url",
            "affiliationName": "Ajaya",
            "address_1": "92 Beasley Bend Rd",
            "city": "Riddleton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riddleton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.