LASTACIA PEELE (NPI# 1194144238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194144238 |
| Entity Type | Individual |
| Full Name | LASTACIA PEELE |
| Practice Address |
118 Union St Clarksville TN 37040-5115 |
| Mailing Address |
410 Ambrose Dr Clarksville TN 37042-5101 |
| Practice Telephone | 9316478257 |
| Practice Fax Number | 9316478257 |
| Mailing Telephone | 9313781868 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
118 UNION ST |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37040-5115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346378296 | Ellen Rae Porter | Adult Companion | 118 Union St, Clarksville, TN 37040-5115 | 2007-03-01 |
| 1508472077 | Ruth Ann Maduka | Counselor | 118 Union St, Clarksville, TN 37040-5115 | 2020-09-21 |
| 1922629815 | Hailey Breanne Warren | Counselor | 118 Union St, Clarksville, TN 37040-5115 | 2020-05-01 |
| 1831722941 | Marcie Theresa Wolter | Technician | 118 Union St, Clarksville, TN 37040-5115 | 2020-02-17 |
| 1083263883 | Patricia Shepherd | Counselor | 118 Union St, Clarksville, TN 37040-5115 | 2019-09-05 |
| 1114589835 | Regina Yvonne Ferrell | Case Manager/Care Coordinator | 118 Union St, Clarksville, TN 37040-5115 | 2019-07-02 |
| 1588156673 | Sarah Gilleran | Technician | 118 Union St, Clarksville, TN 37040-5115 | 2018-06-04 |
| 1992210538 | Breanna Kaitlyn Browder | Counselor | 118 Union St, Clarksville, TN 37040-5115 | 2017-12-05 |
| 1407383854 | Amber Marie Dunbar | Counselor | 118 Union St, Clarksville, TN 37040-5115 | 2017-05-16 |
| 1821541772 | Deasia Wright | Counselor | 118 Union St, Clarksville, TN 37040-5115 | 2016-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124380 | Clarksville Treatment Center, LLC | Clinic/Center | 495 Dunlop Lane, Clarksville, TN 37040 | 2019-10-04 |
| 1295384956 | Dena Marie Borchick | Technician | 3779 Cindy Jo Dr. N, Clarksville, TN 37040 | 2019-09-05 |
| 1477014488 | Emily Allen | Dentist | 930 Hwy 76, Clarksville, TN 37040 | 2019-03-31 |
| 1730640566 | Latoya Ewert | Counselor | Centerstone Clarksville Harriet Cohn Center, 511 8th Street, Clarksville, TN 37040 | 2019-03-26 |
| 1356811988 | Jamie Coles | Behavior Technician | 851 Professional Park Drive 851 Profesiional Park Drive, Clarksville, TN 37040 | 2018-11-27 |
| 1518448554 | Bandel Counseling Service | Clinic/Center | 113 3rd St., Suite 25, Clarksville, TN 37040 | 2018-08-28 |
| 1477052520 | Bridget Stokes | Behavior Technician | 2277 Wilma Rudolph Blvd., Suite C #259, Clarksville, TN 37040 | 2018-02-05 |
| 1053824334 | Sandra Loren Coates | Nurse Practitioner | 980 Professional Park Dr Ste C, Clarksville, TN 37040 | 2017-11-09 |
| 1902328362 | Terri Brooke Roach | Registered Nurse | 651 Dunlop Lane, Clarksville, TN 37040 | 2017-07-07 |
| 1093244428 | Nikkia Deneil Bell | Behavior Technician | 139 E. Old Trenton Rd, Suite B, Clarksville, TN 37040 | 2017-06-08 |
| Find all providers in zip 37040 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699202457 | Jelessa Lashae Crosby-powell | Community Based Residential Treatment Facility, Mental Illness | 2010 Tynewood Dr, Clarksville, TN 37042-5284 | 2017-05-11 |
| 1902260805 | Sharon Gilgenast | Community Based Residential Treatment Facility, Mental Illness | 1279 Cloverdale Dr, Clarksville, TN 37040-4714 | 2016-04-07 |
| 1689040289 | Shemeka Lajuana Jenkins | Community Based Residential Treatment Facility, Mental Illness | 118 Union Stret, Clarksville, TN 37040 | 2015-08-18 |
| 1669890281 | Marian Davis | Community Based Residential Treatment Facility, Mental Illness | 100 Ballygar St Apt M, Clarksville, TN 37043-2800 | 2014-04-01 |
| 1437409620 | Shanice Renee Stewart | Community Based Residential Treatment Facility, Mental Illness | 3369 Durrett Dr, Apt. 73, Clarksville, TN 37042-8630 | 2012-09-14 |
| 1366835381 | Lindsey Harper | Community Based Residential Treatment Facility, Mental Illness | 118 Union St, Clarksville, TN 37040-5115 | 2015-03-16 |
| 1851700272 | Lena Cantrell | Community Based Residential Treatment Facility, Mental Illness | 118 Union St, Clarksville, TN 37040-5115 | 2014-08-11 |
| 1841623543 | Esther Washington | Community Based Residential Treatment Facility, Mental Illness | 118 Union St, Clarksville, TN 37040-5115 | 2013-08-16 |
| 1306197215 | Sylvia Rose Smith | Community Based Residential Treatment Facility, Mental Illness | 118 Union St, Clarksville, TN 37040-5115 | 2012-10-02 |
| 1689954117 | Terry Bailey Nix Jr | Community Based Residential Treatment Facility, Mental Illness | 118 Union St, Clarksville, TN 37040-5115 | 2011-08-29 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37040 |
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| 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.