Individual provider Active NPI

Carri Ann McClellan, MA, LPC-MHSP-S, LMHC

  • Professional Counselor
  • Knoxville, TN
National Provider Identifier
1932343837
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6664 Issued in TN
Practice address
201 W Springdale Ave
Knoxville, TN 37917-5158
Phone
(865) 637-9711
NPI assigned
Apr 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 6664 TN Primary

Addresses

Primary practice location

201 W Springdale Ave
Knoxville, TN 37917-5158

Mailing address

10904 Kingston Pike Ste 101
Knoxville, TN 37934-2952
Phone (865) 568-5489

Other names 1

  • Carri Ann McCrary Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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
I20241028000654 TN Practitioner - Mental Health Counselor 5799062857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6664TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Mind Counseling Services, Inc CurrentSince Sep 16, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

6305 Lonas Dr
Ste 101
Knoxville, TN 37909
Phone (865) 584-0291

11840 Kingston Pike
Ste B
Knoxville, TN 37934

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1932343837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10904 KINGSTON PIKE STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342952",
            "telephone_number": "865-568-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175158",
            "telephone_number": "865-637-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "CARRI",
        "middle_name": "ANN",
        "credential": "MA, LPC-MHSP-S, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "6664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Lancaster Dr NE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973051221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARRI",
            "last_name": "MCCRARY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.