Jessalyn Medlock, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

6421 Rabbit Creek Rd
Buchanan, TN 38222-4003

Phone

(731) 441-1867

NPI assigned

Mar 20, 2019

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

• Connections Prayer Ministries

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paris, TN
  • NPI 1801666581
  NPD Authorized official

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1922568799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 RABBIT CREEK RD",
            "city": "BUCHANAN",
            "state": "TN",
            "postal_code": "382224003",
            "telephone_number": "731-441-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 RABBIT CREEK RD",
            "city": "BUCHANAN",
            "state": "TN",
            "postal_code": "382224003",
            "telephone_number": "731-441-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLOCK",
        "first_name": "JESSALYN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "11247",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Lynn Davidson, PA-C
• Jessica French
• Kimberly Johnson
• Helen G Kirby, PTA
• Alyssa Kocher
• Tonya Hayes Nash, MSPAS, PA
• Stephanie Roberts, LPC-MHSP

• Clinical Social Worker in Buchanan, TN
• Providers in Buchanan, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.