Healthcare Provider Details

I. General information

NPI: 1922977198
Provider Name (Legal Business Name): MADEWELL MINDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 MARTIN LUTHER KING JR AVE STE V701
KNOXVILLE TN
37915-1621
US

IV. Provider business mailing address

2425 MARTIN LUTHER KING JR AVE STE V701
KNOXVILLE TN
37915-1621
US

V. Phone/Fax

Practice location:
  • Phone: 865-224-6021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS SHANNON RHAMES KEITH
Title or Position: FOUNDER AND CEO
Credential: PHD
Phone: 865-224-6021