Justin Donnelly, M.S.

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

000-1205 Issued in TN

Practice address

135 Quita Cir Apt B
Lebanon, TN 37087-4440

Phone

(615) 955-1729

NPI assigned

Mar 8, 2016

Sex

Male

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Clover Mental Health LLC

  • Counseling Psychologist
  • Lebanon, TN
  • NPI 1457971087
  NPD Authorized official
• Yapa Dba Project Transition

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Nashville, TN
  • NPI 1346606787
  NPD (past)

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1861853657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 QUITA CIR APT B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874440",
            "telephone_number": "615-955-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 QUITA CIR APT B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874440",
            "telephone_number": "615-955-1729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Lebanon Pike",
            "address_2": "ste 2102",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372142230",
            "country_code": "US",
            "telephone_number": "615-526-1916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-08",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TN",
            "license": "000-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Dent, PHARMD
• Dialysis Clinic Inc.
• Sara Marie Dicken, PA-C
• Jessica Ann Ditto, O.D.
• Doctors Office LLC
• Heather Hancock Dooley, AU.D, CCC-A
• Marissa Denise Dopson, DDS, MPH
• Double Lung PC (Total Family Physicians Center)
• Gabrielle N Doyle, FNP
• Dr Fred Davis and Associates

• Peer Specialist in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Peer Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.