1386084424 NPI number — MRS. JESSICA CHASTAIN TEWELL MSW, M.DIV., LCSW

Table of content: MRS. JESSICA CHASTAIN TEWELL MSW, M.DIV., LCSW (NPI 1386084424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386084424 NPI number — MRS. JESSICA CHASTAIN TEWELL MSW, M.DIV., LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TEWELL
Provider First Name:
JESSICA
Provider Middle Name:
CHASTAIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, M.DIV., LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHASTAIN
Provider Other First Name:
JESSICA
Provider Other Middle Name:
LYNNE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386084424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 CALEDONIA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28734-1797
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-361-7901
Provider Business Mailing Address Fax Number:
828-837-5309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 CALEDONIA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28734-1797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-361-7901
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904017159 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: C009647 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CSW009497 . This is a "GA BOARD OF COUNSELORS, SOCIAL WORKERS, AND MARRIAGE AND FAMILY THERAPISTS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 0904017159 . This is a "VIRGINIA BOARD OF SOCIAL WORKERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".