| Stephanie Goodrum, LPC | |
|
641 E Poplar Ave, Selmer, TN 38375-1828 | |
| (731) 645-5753 | |
| (731) 645-9885 |
| Full Name | Stephanie Goodrum |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 29 Years |
| Location | 641 E Poplar Ave, Selmer, Tennessee |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972611788 | NPI | - | NPPES |
| 4099873 | Other | TN | BCBS PROVIDER NUMBER |
| 572994000 | Medicaid | TN |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mental Health Centers And Clinics Of Tennessee | 3678475621 | 12 |
| Entity Name | Mental Health Centers & Clinics Of Tennessee |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255442794 PECOS PAC ID: 3678475621 Enrollment ID: O20040121001005 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Goodrum, LPC 3772 Highway 45 S, Selmer, TN 38375-6606 Ph: (731) 645-5753 | Stephanie Goodrum, LPC 641 E Poplar Ave, Selmer, TN 38375-1828 Ph: (731) 645-5753 |
Jessica Sain, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885 | |
Tressel Ball, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 173-164-5575 Fax: 731-645-9885 | |
Matthew Tyler Jernigan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885 | |
Vanesssa K Warren, BSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885 | |
Tami Buck, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885 | |
Jonathan Harrison, M.MIN Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885 | |
Kirby Redmon, BUS Counselor Medicare: Not Enrolled in Medicare Practice Location: 641 E Poplar Ave, Selmer, TN 38375 Phone: 731-645-5753 Fax: 731-645-9885 |