Active NPI
Lacey Beth Fadelle, MMFT, LMFT
- Marriage & Family Therapist
- Brentwood, TN
National Provider Identifier
1821666538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1711
- Practice address
- 7101 Peach CT
Brentwood, TN 37027-5279 - Phone
- (615) 714-2733
- NPI assigned
- Jun 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1711 | TN | Primary |
Addresses
Primary practice location
7101 Peach CT
Brentwood, TN 37027-5279
Mailing address
1024 Manley LN
Brentwood, TN 37027-5501
Phone (615) 714-2733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 28, 2024 through Feb 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623888000000",
"number": "1821666538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1024 MANLEY LN",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275501",
"telephone_number": "615-714-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7101 PEACH CT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275279",
"telephone_number": "615-714-2733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADELLE",
"first_name": "LACEY",
"middle_name": "BETH",
"credential": "MMFT, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "1711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.