Individual provider Active NPI

Remington Vandergriff, LCSW

  • Clinical Social Worker
  • Clarksville, TN
National Provider Identifier
1780921031
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6727 Issued in TN
Practice address
140 Wallace Blvd
Clarksville, TN 37042-0923
Phone
(931) 914-4807
NPI assigned
Jan 7, 2013
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0136581TELE VT
Clinical Social Worker 1041C0700X 6727 TN Primary
Clinical Social Worker 1041C0700X SWB-2025-0430 NM
Clinical Social Worker 1041C0700X C009347 NC
Clinical Social Worker 1041C0700X TLS1609CP SC
Clinical Social Worker 1041C0700X 7071070 ID
Clinical Social Worker 1041C0700X TPSW5583 FL

Addresses

Primary practice location

140 Wallace Blvd
Clarksville, TN 37042-0923

Mailing address

140 Wallace Blvd Ste 7
Clarksville, TN 37042-0924
Phone (931) 914-4807

Other practice location 1

1792 Patricia Dr
Clarksville, TN 37040-7345
Phone (931) 914-4807

Other practice location 2

1792 Patricia Dr
Clarksville, TN 37040-7345
Phone (931) 914-4807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TPSW5583FLMDClinical Social Worker
7071070IDMDClinical Social Worker
SWB-2025-0430NMMDClinical Social Worker
TLS1609CPSCMDClinical Social Worker
089.0136581TELEVTMDClinical Social Worker
6727TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bonafide Therapeutic Alliance LLC Clinical CurrentSince Oct 12, 2025 Accepting new patients

Locations

140 Wallace Blvd
Clarksville, TN 37042
Phone (931) 914-4807

140 Wallace Blvd
Ste 7
Clarksville, TN 37042

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1780921031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WALLACE BLVD STE 7",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370420924",
            "telephone_number": "931-914-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WALLACE BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370420923",
            "telephone_number": "931-914-4807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1792 Patricia Dr",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370407345",
            "country_code": "US",
            "telephone_number": "931-914-4807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1792 Patricia Dr",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370407345",
            "country_code": "US",
            "telephone_number": "931-914-4807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERGRIFF",
        "first_name": "REMINGTON",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0136581TELE",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6727",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2025-0430",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009347",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "TLS1609CP",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "7071070",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "TPSW5583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.