MR. JOHN MICHAEL CHILDRESS (NPI# 1568662781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568662781 |
| Entity Type | Individual |
| Full Name | MR. JOHN MICHAEL CHILDRESS |
| Credential | LCSW |
| Practice Address |
Blanchfield Army Community Hospital 650 Jole Drive Fort Campbell KY 42223-5349 |
| Practice Telephone | 2707988727 |
| Practice Fax Number | 2709560180 |
| Mailing Telephone | 2707988727 |
| Mailing Fax Number | 2709560180 |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CW015017 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | UPIN | VAD001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275551673 | John Frederick Childress IIi | Psychologist | 810 Westwood Office Park, Fredericksburg, VA 22401-5121 | 2006-07-17 |
| 1164986329 | John Childress Iv | Case Manager/Care Coordinator | 4968 Glenway Ave, Cincinnati, OH 45238-3902 | 2019-01-22 |
| 1780902841 | John Clyde Childress IIi | Radiology | 700 E Morehead St, Ste 300, Charlotte, NC 28202-2788 | 2010-05-13 |
| 1134157605 | John M. Childress | Emergency Medicine | 234 Goodman St, Cincinnati, OH 45219-2364 | 2006-06-30 |
| Street Address |
BLANCHFIELD ARMY COMMUNITY HOSPITAL 650 JOLE DRIVE |
| City | FORT CAMPBELL |
| State | KY |
| Zip Code | 42223-5349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992776991 | Gordon Troy Prairie | Family Medicine | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2006-01-28 |
| 1477181428 | Aaron Alan Hardy | Physician Assistant | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-03-27 |
| 1598390452 | Raymond L. Hernandez | Physician Assistant | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223-5349 | 2020-03-11 |
| 1053801886 | Mark Leon Siebe | Family Medicine | Blanchfield Army Community Hospital, 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2018-05-17 |
| 1891283842 | Blake Adam Glynn | Physician Assistant | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2018-04-25 |
| 1407363575 | Sean Patrick Casey Stewart | Pharmacist | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2018-01-10 |
| 1871020081 | Marquita Sheree Barr | Social Worker | Blanchfield Army Community Hospital, 650 Joel Dr, Fort Campbell, KY 42223-5349 | 2017-05-18 |
| 1346776465 | Curtiss Mills | Family Medicine | Blanchfield Army Community Hospital, 650 Joel Dr, Fort Campbell, KY 42223 | 2017-05-10 |
| 1497295240 | Sarahlouise Perez | Counselor | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2017-02-27 |
| 1134675481 | Joseph Flynn Drevlow | Physician Assistant | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2016-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| Find all providers in zip 42223 | ||||
| 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 |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1962990333 | Amanda Aguirre | Social Worker | 8337 Nichols St Apt B, Fort Campbell, KY 42223-2610 | 2018-05-01 |
| 1124438726 | Michael Bell | Social Worker | Blanchfield Army Community Hospital Attn: Credentials, 650 Joel Drive, Fort Campbell, KY 42223 | 2014-05-05 |
| 1043541683 | Stephanie C Craig | Social Worker | 5661 Screaming Eagle Blvd, Fort Campbell, KY 42223-5405 | 2010-01-21 |
| 1104055961 | Julie Maria Howard | Social Worker | 650 Joel Dr Bldg E, Fort Campbell, KY 42223-5318 | 2009-07-14 |
| 1124234414 | Howard W Taylor | Social Worker | 22nd Street, Bldg 2523, Fort Campbell, KY 42223 | 2007-05-15 |
| 1972110260 | Lily Marisa Rodriguez | Social Worker | 650 Joel Drive, Fort Campbell, KY 42223-5349 | 2020-09-30 |
| 1053888602 | Joel Price | Social Worker | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2018-10-31 |
| 1457845646 | Ashley Curtman | Social Worker | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2018-06-20 |
| 1639691306 | Danielle Rene Salvatore | Social Worker | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2017-07-13 |
| Find all providers in FORT CAMPBELL | ||||
| City | FORT CAMPBELL |
| Zip Code | 42223 |
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| 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.