COFFEE ASSOCIATES A MEDICAL MANAGEMENT ORGANIZATION, LLC (NPI# 1760926075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760926075 |
| Entity Type | Organization |
| Organization Name | COFFEE ASSOCIATES A MEDICAL MANAGEMENT ORGANIZATION, LLC |
| Other Organization Name | RAPHA CENTRE |
| Practice Address |
482 Interstate Dr Suite D Manchester TN 37355-3485 |
| Practice Telephone | 9314441000 |
| Practice Fax Number | 9314508256 |
| Mailing Telephone | 9314441000 |
| Mailing Fax Number | 9314508256 |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |
| Authorized Official Name | MR. JOSEPH CLIFTON CHESTER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9314441000 |
| Authorized Official Credential | LPC-MHSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
3079 | TN | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LSW000000003614 | TN | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Rapha Centre | Doing Business As Name - Organization |
| Street Address |
482 INTERSTATE DR SUITE D |
| City | MANCHESTER |
| State | TN |
| Zip Code | 37355-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467489500 | Donna E Tudor | Nurse Practitioner | 482 Interstate Dr, Ste A, Manchester, TN 37355-3109 | 2006-06-26 |
| 1043537046 | Coffee Medical Group LLC | Clinic/Center | 482 Interstate Dr, Suite A, Manchester, TN 37355-3109 | 2010-04-29 |
| 1376570424 | Albert R Brandon Jr. | Family Medicine | 482 Interstate Dr, Ste A, Manchester, TN 37355-3109 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857126 | Ashley Harmon Layne | Speech-Language Pathologist | 205 S Woodland St, Manchester, TN 37355 | 2018-07-17 |
| 1760996771 | Quad/med, LLC | Clinic/Center | 227 Monogard Rd, Manchester, TN 37355 | 2017-11-29 |
| 1881108157 | Sarabeth Seagreaves | Specialist/Technologist | 1700 Summer St Apt A36, Manchester, TN 37355 | 2017-11-25 |
| 1639618663 | Heather N Fesmire | Surgery | 1030 Mcarthur St., Manchester, TN 37355 | 2017-02-23 |
| 1316361561 | Charlotte Gibbs | Counselor | 482 Interstate Dr Ste D, Manchester, TN 37355 | 2014-02-08 |
| 1205258191 | Aleene Marie Falk | Social Worker | 218 Forrestwood Drive, Manchester, TN 37355 | 2014-01-10 |
| 1790067429 | Reda Lynn Lawson | Registered Nurse | 800 Parks Street, Manchester, TN 37355 | 2011-09-20 |
| 1912294117 | Patricia Beth Elliott | Nurse Practitioner | 804 Keylon Street, Manchester, TN 37355 | 2011-07-08 |
| 1427241421 | Kimberly D. Mathis | Nurse Practitioner | 1600 Mcarthur Street, Manchester, TN 37355 | 2007-08-22 |
| 1982761441 | Richard Eugene Fishbein | Orthopaedic Surgery | 102 East High Street, Manchester, TN 37355 | 2007-01-03 |
| Find all providers in zip 37355 | ||||
| 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 |
|---|---|---|---|---|
| 1730799099 | T.r.u.e. Self Counseling | Social Worker | 642 Hilliard St Ste 1310, Manchester, CT 06042-2700 | 2020-08-03 |
| 1992328710 | Cheryl Kinney | Social Worker | 623 Meramec Station Rd, Manchester, MO 63021-5550 | 2020-05-27 |
| 1649818857 | Amanda Duenas | Social Worker | 26 Hamlin St, Manchester, CT 06040-5319 | 2019-12-18 |
| 1386288009 | Monica Diaz | Social Worker | 117 East Center Street, Suite A1, Manchester, CT 06040 | 2019-11-06 |
| 1700344165 | Morgan Moller | Social Worker | 200 W Center St Ste C-2-6, Manchester, CT 06040-4864 | 2019-03-05 |
| 1336615103 | Sarah Canning Howroyd | Social Worker | 341 Bidwell St, Manchester, CT 06040-6470 | 2018-10-19 |
| 1023583374 | Melissa K Bascom | Social Worker | C/o Care Coordination Department, 1 Elliot Way, Manchester, NH 03103 | 2018-10-12 |
| 1497239016 | Erin Macdonald Lajeunesse | Social Worker | 182 Kearsarge St, Manchester, NH 03102-3402 | 2018-09-19 |
| 1316420987 | Filomena Dasilva-clark | Social Worker | 284 N Bay St, Manchester, NH 03104-2324 | 2018-09-10 |
| 1386127009 | Susannah Blass Dipasquale | Social Worker | 2 Pinewood Rd, Manchester, MA 01944-1036 | 2018-09-09 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 37355 |
Please comment or provide details below to improve the information on COFFEE ASSOCIATES A MEDICAL MANAGEMENT ORGANIZATION, 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.