JAN CARLTON COLLUM (NPI# 1174917843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174917843 |
| Entity Type | Individual |
| Full Name | JAN CARLTON COLLUM |
| Credential | NCAC1; SAP; TN LICEN |
| Practice Address |
6148 Lee Hwy Ste 208 C/o Bernard & Associates, PC; One Park Place Chattanooga TN 37421-2994 |
| Mailing Address |
8105 Caneadea Trl Chattanooga TN 37421-8210 |
| Practice Telephone | 4233642899 |
| Mailing Telephone | 4233642899 |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2015-03-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LDC0000000181 | TN | Behavioral Health & Social Service Providers |
| Street Address |
6148 LEE HWY STE 208 C/O BERNARD & ASSOCIATES, PC; ONE PARK PLACE |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-2994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821332818 | William Hoyt Daniel Sr. | Counselor | 3661 Brainerd Rd, Suite 304, Chattanooga, TN 37411-3695 | 2012-11-15 |
| 1770768236 | Richard J. Swistek | Counselor | 1401 Williams St, Suite 206, Chattanooga, TN 37408-1101 | 2008-01-03 |
| 1508089681 | Adam David Arsenault | Counselor | 100 Cherokee Blvd Ste 301, Chattanooga, TN 37405-3886 | 2007-04-10 |
| 1639218753 | John L Morrison | Counselor | 1800 Mc Callie Avenue, Chattanooga, TN 37404-3025 | 2007-02-05 |
| 1598767444 | Christopher D Prater | Counselor | 105 Lee Parkway Dr, Suite A, Chattanooga, TN 37421-6708 | 2005-08-11 |
| 1861001943 | Sarah Lynne Davis | Counselor | 2347 Rossville Blvd, Chattanooga, TN 37408-2250 | 2020-07-24 |
| 1548893100 | Cressie Tambling | Counselor | 2347 Rossville Blvd, Chattanooga, TN 37408-2250 | 2020-02-21 |
| 1134752702 | Linda Leverett | Counselor | 2347 Rossville Blvd, Chattanooga, TN 37408-2250 | 2020-02-21 |
| 1033754668 | Michelle Rhea Gudger | Counselor | 2347 Rossville Blvd, Chattanooga, TN 37408-2250 | 2019-11-07 |
| 1477197507 | Tiffany Isabel Hove | Counselor | 2347 Rossville Blvd, Chattanooga, TN 37408-2250 | 2019-11-01 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
Please comment or provide details below to improve the information on JAN CARLTON COLLUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.