MEDICARE: ADVANCED THERAPY SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	103K00000X	Behavior Analyst
5	1041C0700X	Clinical Social Worker		TN
6	106H00000X	Marriage & Family Therapist
7	106S00000X	Behavior Technician
8	2251P0200X	Pediatric Physical Therapist
9	225200000X	Physical Therapy Assistant
10	225XP0200X	Pediatric Occupational Therapist
11	235Z00000X	Speech-Language Pathologist	SP0000001494	TN
12	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	20795	TN
13	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
14	261QP2000X	Physical Therapy Clinic/Center
15	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	I000000020795	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4152748	OTHER	TN	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326269119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED THERAPY SOLUTIONS

Provider Business Mailing Address
First Line	:	851 PROFESSIONAL PARK DR
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-5257
Country	:	US
Telephone Number	:	931-542-2168
Fax Number	:	931-542-2206

Provider Business Practice Location Address
First Line	:	851 PROFESSIONAL PARK DR
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-5257
Country	:	US
Telephone Number	:	931-542-2168
Fax Number	:	931-542-2206

Authorized Official
Title or Position	:	CO OWNER
Name	:	SUSAN JOHNSON LINGG
Credential	:
Telephone Number	:	931-542-2168

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	05/24/2022

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