Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Natalie Grace Wigle, LCSW

Individual provider Clinical Social Worker · NPI 1710522636

Natalie Grace Wigle, LCSW is a Clinical Social Worker in Johnson City, Tennessee. Graduated from East Tennessee State University Quillen College of Medicine in 2016, 10 years ago. Practices with Revitalist, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
10
Trained at
East Tennessee State University Quillen College of Medicine
Licensed in
TN
In the registry since
2019
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

508 Princeton Rd Ste 403
Johnson City, TN 37601-2064
Phone: (888) 214-2144
Fax: (866) 693-2298
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4625 E Bay Dr Ste 103, Clearwater, FL 33764-6866 — (888) 214-2144

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LSW0000007194 (TN)
Professional Counselor Taxonomy 101YP2500X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1710522636
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 14, 2019
Last updated in NPPESMay 22, 2026
Certification dateMay 22, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolEAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Revitalist — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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