MR. JUSTIN DONNELLY (NPI# 1861853657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861853657 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN DONNELLY |
| Credential | M.S. |
| Practice Address |
135 Quita Cir Apt B Lebanon TN 37087-4440 |
| Practice Telephone | 6159551729 |
| Mailing Telephone | 6159551729 |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2020-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | TN | Other Service Providers | |
| Y | 175T00000X | Peer Specialist | 000-1205 | TN | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3055 Lebanon Pike, Ste 2102, Nashville, TN 372142230 | 6155261916 |
| Street Address |
135 QUITA CIR APT B |
| City | LEBANON |
| State | TN |
| Zip Code | 37087-4440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971087 | Clover Mental Health LLC | Case Management | 135 Quita Cir Apt B, Lebanon, TN 37087-4440 | 2020-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051698 | Results-ast Jv, LLC | Physical Therapist | 1420 West Baddour Parkway, Suite 102, Lebanon, TN 37087 | 2020-10-19 |
| 1306405725 | Angela Kurtz | Hearing Instrument Specialist | 1430 West Baddour Parkwayste D, Lebanon, TN 37087 | 2019-06-10 |
| 1164926937 | Andrea Christine Morrisett | Physical Therapist | 404 N Castle Heights Ave Ste G, Lebanon, TN 37087 | 2018-03-19 |
| 1942731492 | Rocky Mountain Holdings, LLC | Ambulance | 760d Franklin Rd, Lebanon, TN 37087 | 2017-03-27 |
| 1326409285 | Karina Lawrence | Speech-Language Pathologist | 1006 Keaton Street, Lebanon, TN 37087 | 2016-03-18 |
| 1174910491 | Yehualashet Bekele Hailemariam | Internal Medicine | 1411 W Baddour Pkwy,lebanon Tn 37087, Lebanon, TN 37087 | 2015-04-24 |
| 1043614829 | Jean Thompson | Behavioral Analyst | 1004 Hickory Hill Lane, Suite 2, Hermitage, TN 37087 | 2014-10-22 |
| 1588072771 | La Keisha Fair | Community Health Worker | 1 Cumberland Square, Lebanon, TN 37087 | 2014-07-31 |
| 1023440609 | James Martin Meadows | Specialist/Technologist | One Cumberland Square, Lebanon, TN 37087 | 2013-08-06 |
| 1336571231 | Lori Ann De Leo | Social Worker | 109 Autumn Creek, Lebanon, TN 37087 | 2013-08-01 |
| Find all providers in zip 37087 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851944482 | Stacey Stokes | Peer Specialist | 1413 Bailey Ave, Chattanooga, TN 37404 | 2019-07-23 |
| 1891264453 | George Allen Clay | Peer Specialist | 509 S Highland Park Ave, Chattanooga, TN 37404-2932 | 2018-11-13 |
| 1720437189 | Ronda Schrimsher | Peer Specialist | 108 E Lauderdale St, Tullahoma, TN 37388 | 2016-06-07 |
| 1336748375 | Lydia Stoutt | Peer Specialist | 320 W 3rd North St, Morristown, TN 37814-4038 | 2020-10-21 |
| 1730787706 | Trey Lovelace | Peer Specialist | 310 W 3rd North St, Morristown, TN 37814-4038 | 2020-10-13 |
| 1386251684 | Terri L Robinson | Peer Specialist | 205 W Springdale Ave, Knoxville, TN 37917-5158 | 2020-09-30 |
| 1629686068 | Mary Franfces Miller | Peer Specialist | 5310 Ball Camp Pike, Knoxville, TN 37921-3234 | 2020-07-22 |
| 1053939256 | Meredith Roxanne Cross | Peer Specialist | 17 Ridgeway Rd, Norris, TN 37828-3071 | 2020-07-14 |
| 1184242638 | Misty Lee Matheney | Peer Specialist | 839 Wren Rd, Goodlettsville, TN 37072-2316 | 2020-07-10 |
| 1558989434 | Chasity Hope Galyon | Peer Specialist | 2455 Sutherland Ave, Knoxville, TN 37919-2355 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
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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.