Individual provider Active NPI

Trina Marie Middleton, LCSW

  • Clinical Social Worker
  • Cordova, TN
National Provider Identifier
1962576173
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
907LSW Issued in TN
Practice address
58 Timber Creek Dr
Cordova, TN 38018-4233
Phone
(901) 566-1002
Fax
(901) 566-1951
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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 907LSW TN Primary

Addresses

Primary practice location

58 Timber Creek Dr
Cordova, TN 38018-4233

Mailing address

58 Timber Creek Dr
Cordova, TN 38018-4233
Phone (901) 566-1002

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
907LSWTNMDClinical Social Worker
907TNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1962576173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 TIMBER CREEK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184233",
            "telephone_number": "901-566-1002",
            "fax_number": "901-566-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 TIMBER CREEK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184233",
            "telephone_number": "901-566-1002",
            "fax_number": "901-566-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "TRINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "907LSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.