| Professional Care Services Of West Tn, Inc. | |
|
1997 Highway 51 S Covington TN 38019-3630 | |
| (901) 476-8967 | |
| Not Available |
| Full Name | Professional Care Services Of West Tn, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1997 Highway 51 S, Covington, Tennessee |
| Authorized Official Name and Position | Jimmie Jackson (CEO) |
| Authorized Official Contact | 9016221630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Care Services Of West Tn, Inc. 1997 Highway 51 S Covington TN 38019-3630 Ph: (844) 727-2778 | Professional Care Services Of West Tn, Inc. 1997 Highway 51 S Covington TN 38019-3630 Ph: (901) 476-8967 |
| NPI Number | 1457351215 |
|---|---|
| Provider Enumeration Date | 07/22/2005 |
| Last Update Date | 02/26/2024 |
| Certification Date | 02/26/2024 |
| Medicare PECOS PAC ID | 0042115537 |
|---|---|
| Medicare Enrollment ID | O20031208000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457351215 | NPI | - | NPPES |
| Provider Name | Lucas A Trautman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497978258 PECOS PAC ID: 4981742590 Enrollment ID: I20091118000465 |
| Provider Name | Belinda Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811214653 PECOS PAC ID: 4082730064 Enrollment ID: I20100928000116 |
| Provider Name | Anne M Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245586874 PECOS PAC ID: 5799934295 Enrollment ID: I20121003000250 |
| Provider Name | Alam E Sharifi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669873774 PECOS PAC ID: 8224353123 Enrollment ID: I20150218000606 |
| Provider Name | Sarah A Dietrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396149951 PECOS PAC ID: 6507183381 Enrollment ID: I20150317000833 |
| Provider Name | Shellie R Hendren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841470366 PECOS PAC ID: 8820398803 Enrollment ID: I20180829001051 |
| Provider Name | Christy Goforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548727522 PECOS PAC ID: 9830422765 Enrollment ID: I20190610000568 |
| Provider Name | Amanda Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669844023 PECOS PAC ID: 1456787100 Enrollment ID: I20200129000541 |
| Provider Name | Christen L Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982378683 PECOS PAC ID: 6800282716 Enrollment ID: I20220401000455 |
| Provider Name | Brandy Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669051751 PECOS PAC ID: 8729454202 Enrollment ID: I20221025002261 |
| Provider Name | Marissa M Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235867821 PECOS PAC ID: 5496123846 Enrollment ID: I20221116001949 |
| Provider Name | Monika Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629796750 PECOS PAC ID: 6204291917 Enrollment ID: I20230503000364 |
| Provider Name | Nicole Mclemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063131316 PECOS PAC ID: 0042671919 Enrollment ID: I20230726000091 |
| Provider Name | Latonia Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699353714 PECOS PAC ID: 8426401464 Enrollment ID: I20240126000462 |
| Provider Name | Sara Hawkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295964443 PECOS PAC ID: 7719320407 Enrollment ID: I20240209001517 |
| Provider Name | Ricci Hellman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871817627 PECOS PAC ID: 0648611822 Enrollment ID: I20240520000647 |
| Provider Name | Shunda L Mccoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144368192 PECOS PAC ID: 2769924224 Enrollment ID: I20240612000600 |
| Provider Name | Leslie C Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346788700 PECOS PAC ID: 2769927946 Enrollment ID: I20240711003459 |
| Provider Name | Felisha Tillman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194533877 PECOS PAC ID: 2567992035 Enrollment ID: I20250213000141 |
Healthy Minds-healthy Emotions Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 N Maple St, Covington, TN 38019 Phone: 901-403-0281 Fax: 901-284-0304 | |
Restore Mental Health Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 145 W Church Ave, Covington, TN 38019 Phone: 901-481-1759 |