Organization Active NPI

Divergent Roads Counseling

  • Clinical Social Worker
  • Cleveland, TN
National Provider Identifier
1801568761
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DIVERGENT ROADS COUNSELING
Practice address
3505 Adkisson Dr NW Ste 205
Cleveland, TN 37312-6805
Phone
(423) 368-5893
NPI assigned
Sep 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Rachel La Rea Hatchett, LCSWNPI 1740739648
Title
Owner
Phone
(423) 368-5893

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3505 Adkisson Dr NW Ste 205
Cleveland, TN 37312-6805

Mailing address

417 County Road 709
Riceville, TN 37370-5331
Phone (423) 368-5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211013002183 TN Part B Supplier - Clinic/Group Practice 1658779103 Receives reassigned benefits from 3 practitioners
Practice locations: Cleveland, TN

National Provider Directory

National Provider Directory

Locations

3505 Adkisson Dr NW
Ste 205
Cleveland, TN 37312
Phone (423) 368-5893

3575 Adkisson Dr NW
Ste 1030
Cleveland, TN 37312

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1801568761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 COUNTY ROAD 709",
            "city": "RICEVILLE",
            "state": "TN",
            "postal_code": "373705331",
            "telephone_number": "423-368-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 ADKISSON DR NW STE 205",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373126805",
            "telephone_number": "423-368-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGENT ROADS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "HATCHETT",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "LA REA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-368-5893",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.