EAGLES PASSAGE THERAPEUTIC FARM, LLC (NPI# 1427200757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427200757 |
| Entity Type | Organization |
| Organization Name | EAGLES PASSAGE THERAPEUTIC FARM, LLC |
| Practice Address |
2605 Riddle Rd New Market TN 37820-4835 |
| Practice Telephone | 8659323331 |
| Practice Fax Number | 8659323331 |
| Mailing Telephone | 8659323331 |
| Mailing Fax Number | 8659323331 |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2010-12-09 |
| Authorized Official Name | LISA LYNN FRADY (MEMBER/CLINICAL DIRECTOR) |
| Authorized Official Telephone | 8659323331 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LSW0000004526 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | MAGELLAN | 264470000 | 01 |
| TN | CIGNA | 2088872 | 01 |
| TN | BCBST | 4208400 | 01 |
| TN | AETNA | 5389124 | 01 |
| TN | HUMANA-MILITARY | 263470730 | 01 |
| Street Address |
2605 RIDDLE RD |
| City | NEW MARKET |
| State | TN |
| Zip Code | 37820-4835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205456365 | Carolyn Michelle Wright | Physical Therapist | 1457 Indian Cave Rd, New Market, TN 37820-3543 | 2020-04-19 |
| 1669549846 | Brenda J Shrader | Registered Nurse | 901 Nance Rd, New Market, TN 37820-3551 | 2006-11-30 |
| 1578595716 | Charles Joseph Baldwin | Chiropractor | 1746 Kivett Dr, New Market, TN 37820-3626 | 2006-07-07 |
| 1538389606 | Bio Medical Applications of Tennessee Inc | Clinic/Center | 1030 West Us Highway 11e, New Market, TN 37820-4103 | 2007-04-30 |
| 1982834552 | Cornerstone Family Practice, Inc. | Clinic/Center | 1171 W Highway 11e, New Market, TN 37820-4106 | 2009-07-17 |
| 1881156073 | Adrian Dewayne Solomon | Social Worker | 846 Bales Rd, New Market, TN 37820-4131 | 2019-04-05 |
| 1144841925 | Absolute Best Home Care LLC | Home Health | 544 W Highway 11e, New Market, TN 37820-4301 | 2020-05-03 |
| 1508927971 | Tarr Eye & Vision Center | Optometrist | 555 W Highway 11e, New Market, TN 37820-4305 | 2006-12-12 |
| 1235323759 | Blake W Tarr | Optometrist | 555 W Highway 11e, New Market, TN 37820-4305 | 2007-08-28 |
| 1275968349 | Tammy Loy | Physical Therapy Assistant | 1015 Thunder Crest Ln, New Market, TN 37820-4617 | 2013-09-09 |
| Find all providers in zip 37820 | ||||
| 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 |
|---|---|---|---|---|
| 1588965198 | Irmela Grace Macewen Vendemia | Social Worker | 164 W Main St Ste A, New Market, MD 21774-6279 | 2010-11-12 |
| 1114113024 | Margaret Ellsworth Terry | Social Worker | 11670 Old National Pike, Suite 103, New Market, MD 21774-6121 | 2007-09-25 |
| 1043420425 | Paula Carolyn Bell | Social Worker | 10580 Edwardian Ln, New Market, MD 21774 | 2007-05-23 |
| 1154456044 | Shereen Anne Robinson | Social Worker | 5724 Heatherwood Ct, New Market, MD 21774-2916 | 2007-02-22 |
| 1205306651 | Cristine Marie Zocchi | Social Worker | 125 W Main St, New Market, MD 21774-6210 | 2018-11-28 |
| 1841769635 | Stephanie Hagan | Social Worker | 125 W Main St, New Market, MD 21774-6210 | 2018-11-21 |
| 1548618598 | Mollie Widdowson | Social Worker | 11670 Old National Pike, 103, New Market, MD 21774-6123 | 2016-06-01 |
| 1750708160 | Eve Maitland Taglang | Social Worker | 164 W Main St, A, New Market, MD 21774-6279 | 2014-03-24 |
| 1811313331 | Kaytlin Lapsa | Social Worker | 164 W Main St, New Market, MD 21774-6279 | 2014-03-07 |
| 1922430388 | Cassandra Kay Marshall | Social Worker | 164 W Main St, New Market, MD 21774-6279 | 2013-08-07 |
| Find all providers in NEW MARKET | ||||
| City | NEW MARKET |
| Zip Code | 37820 |
Please comment or provide details below to improve the information on EAGLES PASSAGE THERAPEUTIC FARM, LLC.
| 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.