Active NPI
Rebecca Kelly Cardona, LPC-MHSP, PHD
- Professional Counselor
- Wartburg, TN
National Provider Identifier
1831409168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1893
- Practice address
- 224 Old Mill Rd
Wartburg, TN 37887-4163 - Phone
- (423) 346-6221
- Fax
- (423) 346-3447
- NPI assigned
- Oct 20, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1893 | TN | Primary |
Addresses
Primary practice location
224 Old Mill Rd
Wartburg, TN 37887-4163
Mailing address
PO Box 408
Wartburg, TN 37887-0408
Phone (423) 346-6221
Other practice location 1
3006 Lake Brook Blvd
Knoxville, TN 37909-1137
Phone (865) 246-1100 ext. 225
Other names 1
- Rebecca Kelly
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1893 | TN | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morgan County Health Council Inc | Past | Accepting new patients | |
| Child and Family Tennessee | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Knoxville, TN
- NPI 1134226343
-
- Federally Qualified Health Center (FQHC)
- Wartburg, TN
- NPI 1720099419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570665600000",
"number": "1831409168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 408",
"city": "WARTBURG",
"state": "TN",
"postal_code": "378870408",
"telephone_number": "423-346-6221",
"fax_number": "423-346-3447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 OLD MILL RD",
"city": "WARTBURG",
"state": "TN",
"postal_code": "378874163",
"telephone_number": "423-346-6221",
"fax_number": "423-346-3447"
}
],
"practiceLocations": [
{
"address_1": "3006 Lake Brook Blvd",
"address_purpose": "LOCATION",
"city": "Knoxville",
"state": "TN",
"postal_code": "379091137",
"country_code": "US",
"telephone_number": "865-246-1100 x225",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARDONA",
"first_name": "REBECCA",
"middle_name": "KELLY",
"credential": "LPC-MHSP, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-20",
"last_updated": "2019-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "1893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "REBECCA",
"last_name": "KELLY",
"credential": "LPC-MHSP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wartburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.