| Midsouth Mental Health Llc | |
|
1331 Union Ave Ste 1000 Memphis TN 38104-7501 | |
| (901) 870-2727 | |
| Not Available |
| Full Name | Midsouth Mental Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 1331 Union Ave Ste 1000, Memphis, Tennessee |
| Authorized Official Name and Position | Tamika Davis (DIRECTOR) |
| Authorized Official Contact | 9018702727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsouth Mental Health Llc 1331 Union Ave Ste 1000 Memphis TN 38104-7501 Ph: (901) 870-2727 | Midsouth Mental Health Llc 1331 Union Ave Ste 1000 Memphis TN 38104-7501 Ph: (901) 870-2727 |
| NPI Number | 1366100158 |
|---|---|
| Provider Enumeration Date | 11/30/2021 |
| Last Update Date | 11/30/2021 |
| Certification Date | 11/30/2021 |
| Medicare PECOS PAC ID | 5890174882 |
|---|---|
| Medicare Enrollment ID | O20230410000226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366100158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tamika L Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740418151 PECOS PAC ID: 1153796933 Enrollment ID: I20230410000360 |
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