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General NPI Number Information
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NPI Number | 1922977198
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Entity Type | Organization
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Legal Business Name | MADEWELL MINDS PLLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 2425 MARTIN LUTHER KING JR AVE STE V701
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City | KNOXVILLE
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State | TN
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Zip | 37915-1621
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Country | US
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Telephone | 865-224-6021
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 MARTIN LUTHER KING JR AVE STE V701
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City | KNOXVILLE
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State | TN
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Zip | 37915-1621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | ALEXIS SHANNON RHAMES KEITH
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Credential | PHD
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Telephone | 865-224-6021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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