Individual provider Active NPI

Sylvia Joyce Mudenda-Whaley, LPC MHSP NCC

  • Mental Health Counselor
  • Chattanooga, TN
National Provider Identifier
1801819289
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC0000001755 Issued in TN
Practice address
5726 Marlin Rd
Ste 312
Chattanooga, TN 37411-4008
Phone
(423) 510-0171
Fax
(423) 553-5686
NPI assigned
Jul 26, 2006
Last updated
Apr 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC0000001755 TN Primary
School Counselor 101YS0200X TN

Addresses

Primary practice location

5726 Marlin Rd
Ste 312
Chattanooga, TN 37411-4008

Mailing address

7627 Cecelia Dr
Chattanooga, TN 37416-3216
Phone (423) 855-9947

Other identifiers 2

IdentifierTypeStateIssuer
421619846OtherTNFEDERAL TAX ID
5441063MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC0000001755TNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1801819289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7627 CECELIA DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374163216",
            "telephone_number": "423-855-9947",
            "fax_number": "423-553-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 MARLIN RD",
            "address_2": "STE 312",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374114008",
            "telephone_number": "423-510-0171",
            "fax_number": "423-553-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDENDA-WHALEY",
        "first_name": "SYLVIA",
        "middle_name": "JOYCE",
        "credential": "LPC MHSP NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "LPC0000001755",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "421619846",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5441063",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 14, 2009; 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.