Active NPI
Michael Lynn Waldrop, LMFT
- Marriage & Family Therapist
- Cleveland, TN
National Provider Identifier
1891057147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMT0000000526
- Practice address
- 4028 Bow St NE
Cleveland, TN 37312-4907 - Phone
- (423) 774-5127
- NPI assigned
- Jun 12, 2012
- Last updated
- Jun 12, 2012
- Sex
- Male
- 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 | LMT0000000526 | TN | Primary |
Addresses
Primary practice location
4028 Bow St NE
Cleveland, TN 37312-4907
Mailing address
4028 Bow St NE
Cleveland, TN 37312-4907
Phone (423) 774-5127
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMT0000000526 | TN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1891057147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4028 BOW ST NE",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373124907",
"telephone_number": "423-774-5127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4028 BOW ST NE",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373124907",
"telephone_number": "423-774-5127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDROP",
"first_name": "MICHAEL",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-12",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "LMT0000000526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.