NPIMap

Organization Active NPI

Mental Health Centers & Clinics of Tennessee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chattanooga, TN
National Provider Identifier
1790811149
Registry record updated Oct 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
L214-076-1367 Issued in TN
Legal business name
MENTAL HEALTH CENTERS & CLINICS OF TENNESSEE
Practice address
1028 E 3Rd St
Chattanooga, TN 37403-2107
Phone
(423) 266-6751
Fax
(423) 763-4650
NPI assigned
Feb 27, 2007
Last updated
Oct 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2011

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

Authorized official

Name
Mrs. Melissa Queen-Pennington
Title
Cfo
Phone
(423) 266-6751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X L214-076-1367 TN Primary

Addresses

Primary practice location

1028 E 3Rd St
Chattanooga, TN 37403-2107

Mailing address

6049 Shallowford Road
Chattanooga, TN 37421-1688
Phone (423) 266-6751

Other names 1

  • FORTWOOD CENTER Other name

National Provider Directory

National Provider Directory

Locations

6055 Shallowford Rd
Chattanooga, TN 37421
Phone (423) 763-4606

Practitioners & affiliated clinicians

Practitioners 153

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.

View all 153

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318636800000",
    "number": "1790811149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6049 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-266-6751",
            "fax_number": "423-763-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032107",
            "telephone_number": "423-266-6751",
            "fax_number": "423-763-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH CENTERS & CLINICS OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-10-15",
        "status": "A",
        "authorized_official_last_name": "QUEEN-PENNINGTON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "423-266-6751",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TN",
            "license": "L214-076-1367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORTWOOD CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; 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.