JENNIFER LEIGH MONGOLD (NPI# 1578763470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578763470 |
| Entity Type | Individual |
| Full Name | JENNIFER LEIGH MONGOLD |
| Credential | MA |
| Practice Address |
1570 Waverly Rd Kingsport TN 37664-2523 |
| Mailing Address |
Po Box 9054 Gray TN 37615-9054 |
| Practice Telephone | 4232241300 |
| Practice Fax Number | 4232241375 |
| Mailing Telephone | 4234673600 |
| Mailing Fax Number | 4234673644 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
1570 WAVERLY RD |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664-2523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356372007 | Mary Kathleen O'keeffe | Marriage & Family Therapist | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2006-07-05 |
| 1386257103 | Elizabeth L. Mcfarland | Counselor | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2020-08-31 |
| 1902428014 | Necole L Richardson | Counselor | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2020-05-12 |
| 1922635671 | Calantrica Hunt | Counselor | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2020-03-24 |
| 1497217616 | Kerri Elyse Paulsen | Counselor | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2019-04-05 |
| 1205303674 | Beatrice Sharon Herbert | Licensed Practical Nurse | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2018-10-24 |
| 1508333972 | Heather Nicole Hudson | Licensed Practical Nurse | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2018-10-24 |
| 1093296048 | Matthew Andrews | Social Worker | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2018-08-28 |
| 1285129544 | Gina Monique Brown | Nurse Practitioner | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2018-06-28 |
| 1710482849 | Amber Michelle Anzalone | Case Manager/Care Coordinator | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2018-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1861966525 | Catherine Ann Hensley | Nurse Practitioner | 2995 Fort Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-16 |
| 1679076954 | Christopher A Hillman | Dentist | 1599 Fort Henry Dr Ste 102, Kingsport, TN 37664 | 2018-03-13 |
| 1154666733 | Cristin Patterson | Counselor | 2762 East Center St., Kingsport, TN 37664 | 2012-12-07 |
| 1972851095 | Kevin Michael Smith | Pharmacist | 1425 East Center Street, Kingsport, TN 37664 | 2012-08-21 |
| 1619299617 | Kelli Lynn Dillon | Counselor | 1570 Waverly Rorad, Kingsport, TN 37664 | 2010-02-18 |
| 1356503726 | Charles Craig Stieler | Hearing Instrument Specialist | 2101 Ft Henry Dr, Kingsport, TN 37664 | 2008-06-27 |
| 1104012319 | Pro Balance LLC | Prosthetic/Orthotic Supplier | 2408 Fort Henry Drive, Kingsport, TN 37664 | 2007-09-20 |
| 1518188648 | Remington House | Assisted Living Facility | 640 Rock Springs Road, Kingsport, TN 37664 | 2007-05-02 |
| 1689795007 | Elaine Frazier | Emergency Medicine | 410 Golf Ridge Dr, Kingsport, TN 37664 | 2007-04-03 |
| Find all providers in zip 37664 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851676969 | Angela Nicole Hilton-prillhart | Psychologist | 2020 Meadowview Parkway, Suite 3, Kingsport, TN 37660-1103 | 2011-10-20 |
| 1497066864 | B. Wayne Lanthorn | Psychologist | 3409 E Stone Dr, Kingsport, TN 37660-7001 | 2010-06-30 |
| 1851439988 | Edward E Latham Jr. | Psychologist | 404 E Market St, Kingsport, TN 37660-4828 | 2007-02-01 |
| 1619036159 | Robin Dewanna Wolfe | Psychologist | 404 East Market Street, Kingsport, TN 37660 | 2006-12-08 |
| 1194841445 | Michael Wayne Miller | Psychologist | 1570 Waverly Rd, Kingsport, TN 37664-2523 | 2007-03-21 |
| 1114069531 | Thomas J Burns | Psychologist | 404 E Market St, Kingsport, TN 37660-4828 | 2007-02-13 |
| 1811035967 | Martha S Rubenstein | Psychologist | 404 E Market St, Kingsport, TN 37660-4828 | 2007-02-01 |
| 1164597308 | Elizabeth Ann Jones | Psychologist | 2001 Stonebrook Pl, Assessment and Forensic Services, Kingsport, TN 37660 | 2006-11-22 |
| 1437228723 | Jorge Federico Fuchs | Psychologist | 2001 Stonebrook Place, Kingsport, TN 37660 | 2006-11-08 |
| 1528137874 | Mary Elizabeth Ballard | Psychologist | 2001 Stonebrook Place, Kingsport, TN 37660 | 2006-11-08 |
| Find all providers in KINGSPORT | ||||
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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.