Chantel Okewole, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3935 Issued in TN

Practice address

382 Carriage House Dr Ste D
Jackson, TN 38305-2299

Phone

(602) 391-0044

NPI assigned

May 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Phoenix Neuropsychology and Counseling Center

  • Clinical Psychologist
  • Jackson, TN
  • NPI 1891524930

  Clinical Neuropsychologist

  NPD Authorized official

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1801453402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 CARRIAGE HOUSE DR STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052299",
            "telephone_number": "602-391-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 CARRIAGE HOUSE DR STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052299",
            "telephone_number": "602-391-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEWOLE",
        "first_name": "CHANTEL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TN",
            "license": "3935",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adewale Adeyinka Odukoya, MD
• Kelly K Odum, LCSW
• Francis Fensi Ofori, MD
• Ogi WT JV LLC
• Derick Ogude, MD
• Simon Olalekan Okewole, D.O.
• Chisom C Okpara
• Kyona Olatunji, NP
• Old Folks Mission Center,Inc.
• Aleruchi Oleru, MD

• Clinical Psychologist in Jackson, TN
• Providers in Jackson, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.