Healthcare Provider Details

I. General information

NPI: 1720043615
Provider Name (Legal Business Name): MOUNTAIN PEOPLES HEALTH COUNCILS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3826 NORMA RD
HUNTSVILLE TN
37756-4408
US

IV. Provider business mailing address

470 INDUSTRIAL LN
ONEIDA TN
37841-6294
US

V. Phone/Fax

Practice location:
  • Phone: 423-663-2920
  • Fax: 423-663-3989
Mailing address:
  • Phone: 423-286-4141
  • Fax: 423-286-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC0000003740
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW0000006310
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW0000006084
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000017308
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000024202
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000013549
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0000002075
License Number StateTN
# 8
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000008386
License Number StateTN
# 9
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000013431
License Number StateTN
# 10
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000005568
License Number StateTN
# 11
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000017825
License Number StateTN
# 12
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000016621
License Number StateTN
# 13
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000006765
License Number StateTN
# 14
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateTN

VIII. Authorized Official

Name: MR. JAMES C LOVETT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 423-286-4141