NPIMap

Organization Active NPI

Koselig Health Services PLLC

Doing business as Scruffy City Psychiatry & Psychotherapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
National Provider Identifier
1780382804
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
KOSELIG HEALTH SERVICES PLLC
Doing business as
Scruffy City Psychiatry & Psychotherapy
Practice address
103 Suburban Rd Ste D102
Knoxville, TN 37923-5581
Phone
(865) 424-7334
NPI assigned
Feb 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Ms. Kelsey Wallace, APRNNPI 1285225300
Title
Director/Owner
Phone
(813) 629-0250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

103 Suburban Rd Ste D102
Knoxville, TN 37923-5581

Mailing address

PO Box 10963
Knoxville, TN 37939-0963

Other names 1

  • Scruffy City Psychiatry & Psychotherapy Doing business as

National Provider Directory

National Provider Directory

Locations

103 Suburban Rd
Ste D102
Knoxville, TN 37923
Phone (865) 424-7334

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1780382804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10963",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379390963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SUBURBAN RD STE D102",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235581",
            "telephone_number": "865-424-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSELIG HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "813-629-0250",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scruffy City Psychiatry & Psychotherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.