PEACE OF MIND THERAPY SERVICES (NPI# 1265796072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265796072 |
| Entity Type | Organization |
| Organization Name | PEACE OF MIND THERAPY SERVICES |
| Practice Address |
207 Boone St Suite 27 Johnson City TN 37604-5603 |
| Practice Telephone | 4234443677 |
| Practice Fax Number | 4232440602 |
| Mailing Telephone | 4234443677 |
| Mailing Fax Number | 4232440602 |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2012-06-26 |
| Authorized Official Name | MR. JONATHAN L HARTSELL (THERAPIST) |
| Authorized Official Telephone | 4234443677 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
4902 | TN | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
5391 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | 103I802362 | 01 |
| Street Address |
207 BOONE ST SUITE 27 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-5603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699256628 | Beth Evelyn Barber | Social Worker | 911 Millercrest Dr, Johnson City, TN 37604-4331 | 2018-08-27 |
| 1902258239 | Amber Street | Social Worker | 403 Princeton Rd Ste 2, Johnson City, TN 37601-2040 | 2016-07-11 |
| 1760833164 | Derek Shea Bowers | Social Worker | 207 N Boone St Ste 13, Johnson City, TN 37604-5659 | 2016-06-27 |
| 1952737785 | Carolyn Elaine Conerly | Social Worker | 1185 W Mountain View Rd, 2209, Johnson City, TN 37604-2523 | 2013-09-25 |
| 1326347311 | Jonathan Lynn Hartsell | Social Worker | 207 Boone Street, Suite 27, Johnson City, TN 37604 | 2011-03-16 |
| 1174838932 | Janie Allene Short | Social Worker | 306 W Holston Ave, Johnson City, TN 37604-5526 | 2010-08-17 |
| 1124254990 | Marylyn Beeson Bowman | Social Worker | 169 E Grand Ave, Apt 101, Johnson City, TN 37601-5609 | 2009-06-06 |
| 1336312685 | Lydia Pipes Roane | Social Worker | 703 Hiwassee Hill Dr, Johnson City, TN 37601-7603 | 2008-04-08 |
| 1295954543 | Sharon L Moss | Social Worker | 175 Wyok Rd, Johnson City, NY 13790-4223 | 2007-04-25 |
| 1528132016 | Tammy R. Moody | Social Worker | 332 E Springbrook Dr, Suite 500, Johnson City, TN 37601-1767 | 2006-11-17 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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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.