Individual provider Active NPI

Connie Farmer, LCSW

  • Clinical Social Worker
  • Athens, TN
National Provider Identifier
1881261477
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6573 Issued in TN
Practice address
1805 Ingleside Ave
Athens, TN 37303-2105
Phone
(423) 745-8802
Fax
(423) 744-7064
NPI assigned
Jun 10, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6573 TN Primary

Addresses

Primary practice location

1805 Ingleside Ave
Athens, TN 37303-2105

Mailing address

1805 Ingleside Ave
Athens, TN 37303-2105
Phone (423) 745-8802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210728001505 TN Practitioner - Clinical Social Worker 3971906926 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteer Behavioral Health Care System CurrentSince Jun 1, 2021 Accepting new patients
Volunteer Behavioral Health Care System Past Accepting new patients

Locations

1805 Ingleside Ave
Athens, TN 37303
Phone (423) 745-3367

413 Spring St
Chattanooga, TN 37405
Phone (423) 756-2740

2700 Executive Park NW
Cleveland, TN 37312
Phone (423) 479-9581

1504 Williams Dr
Murfreesboro, TN 37129
Phone (615) 278-2241

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/vbhcs/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1881261477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 INGLESIDE AVE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373032105",
            "telephone_number": "423-745-8802",
            "fax_number": "423-744-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 INGLESIDE AVE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373032105",
            "telephone_number": "423-745-8802",
            "fax_number": "423-744-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "CONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TN

Sources for this page

Verify at the official NPI Registry.