DIVINE SOURCE (NPI# 1316562218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316562218 |
| Entity Type | Organization |
| Organization Name | DIVINE SOURCE |
| Practice Address |
141 Country Club Dr Hendersonville TN 37075-4041 |
| Practice Telephone | 6154284425 |
| Mailing Telephone | 6154284425 |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |
| Authorized Official Name | BARBARA M GILLAM (LICENSED CLINICAL SOCIAL WORK) |
| Authorized Official Telephone | 6154284425 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Divine Source | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Divine Source Healing, LLC | 57 Fairway Road, Southington, CT 06489 |
| Street Address |
141 COUNTRY CLUB DR |
| City | HENDERSONVILLE |
| State | TN |
| Zip Code | 37075-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667425 | Results-ast Jv, LLC | Physical Therapist | 326 New Shackle Island Rd, Suite 300, Hendersonville, TN 37075 | 2020-10-21 |
| 1871126524 | Jessica Elise Williams | Nurse Practitioner | 100 Indian Lake Blvd, Hendersonville, TN 37075 | 2020-02-20 |
| 1003379108 | Infusion Express of Tennessee, PC | Clinic/Center | 1006 Glenbrook Way, Ste 130, Hendersonville, TN 37075 | 2019-04-08 |
| 1417414335 | Red Owl Industries, LLC | Chiropractor | 16 Executive Park Dr # 100, Hendersonville, TN 37075 | 2019-02-27 |
| 1992203368 | Cassie Berman | Occupational Therapist | 209 Shivel Drive, Hendersonville, TN 37075 | 2018-01-31 |
| 1407379373 | Hendersonville Smiles Dentistry, PC | Dentist | 1002 Glenbrook Way, Suite 200, Hendersonville, TN 37075 | 2017-07-21 |
| 1215483466 | Ryan Escue | Registered Nurse | 4221 Harding Pike, Nashville, TN 37075 | 2016-08-28 |
| 1003279589 | Grant Anderson | Physician Assistant | 211 Indian Lake Bloulevard, Hendersonville, TN 37075 | 2016-04-01 |
| 1073974192 | Jennifer Kramer | Nurse Practitioner | 103 Hazel Path Ct, Suite 7, Hendersonville, TN 37075 | 2016-03-16 |
| 1144680315 | Catherine Alexandria Wellendorf | Specialist/Technologist | 3126 Long Hollow Pike, Hendersonville, TN 37075 | 2016-03-02 |
| Find all providers in zip 37075 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912504473 | Linda Herdt | Social Worker | 3110 Hickory Hill Rd, Hendersonville, NC 28792-1230 | 2020-10-07 |
| 1295360493 | Stefanie Dedman | Social Worker | 113 Hazel Path Ste 3, Hendersonville, TN 37075-3878 | 2020-03-08 |
| 1447893409 | Anishia Davis Holman | Social Worker | 107 Imperial Blvd Ste 13, Hendersonville, TN 37075-3441 | 2019-10-22 |
| 1982184040 | Gb Psychology | Social Worker | 110 Edney St Ste A, Hendersonville, NC 28792-5428 | 2018-08-17 |
| 1124506274 | Jonathan Stang | Social Worker | 824 Dale St, Hendersonville, NC 28739-5102 | 2018-07-31 |
| 1962940346 | Mary Ann Butterworth | Social Worker | 120 Chadwick Square Ct, Hendersonville, NC 28739-3201 | 2017-02-06 |
| 1649721911 | Sara R Ross | Social Worker | 48 Reedy Ridge Road, Hendersonville, NC 28792 | 2016-10-20 |
| 1811349244 | Geoffrey Brookshire | Social Worker | 90 Haynes Blvd, Hendersonville, NC 28792-8273 | 2016-07-11 |
| 1639545858 | Ashley Wise | Social Worker | 198 Brittany Place Dr, Apt W, Hendersonville, NC 28792-7116 | 2015-08-12 |
| 1013310820 | Linda Levy Harley, Msw, Lcsw, Pllc | Social Worker | 706 B Fleming Street, Hendersonville, NC 28791-3526 | 2014-10-07 |
| Find all providers in HENDERSONVILLE | ||||
| City | HENDERSONVILLE |
| Zip Code | 37075 |
Please comment or provide details below to improve the information on DIVINE SOURCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.