PSYCHIATRIC SERVICES OF EAST TENNESSEE NPI 1871658757

NPI Information

NPI: 1871658757
Provider Name: PSYCHIATRIC SERVICES OF EAST TENNESSEE
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 44D2262524

Address:
123 E WASHINGTON AVE
ATHENS, TN
ZIP 37303
Phone: (423) 507-8826
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PSYCHIATRIC SERVICES OF EAST TENNESSEE is a substance abuse rehabilitation facility in Athens, TN. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PSYCHIATRIC SERVICES OF EAST TENNESSEE NPI is 1871658757. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

123 E WASHINGTON AVE
ATHENS, TN
ZIP 37303
Phone: (423) 507-8826
Fax: (423) 507-8791

The provider's authorized official is James Robert Stubblefield .
The authorized official title is Coo and has the following contact phone number (865) 722-2761.

The CLIA number assigned to this NPI record is 44D2262524 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2006 and was last updated on 1/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YM0800X	Counselor	Mental Health	No
3	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	No
4	251S00000X	Community/Behavioral Health		No
5	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
6	324500000X	Substance Abuse Rehabilitation Facility		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	241084823	MEDICAID	TENNESSEE
2	4084775	OTHER	TENNESSEE	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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