| Quinco Mental Health Center | |
|
10710 Old Highway 64 Bolivar TN 38008-3587 | |
| (731) 658-6113 | |
| (731) 658-6165 |
| Full Name | Quinco Mental Health Center |
|---|---|
| Speciality | Counselor |
| Location | 10710 Old Highway 64, Bolivar, Tennessee |
| Authorized Official Name and Position | Medlin Marlin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7316586113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quinco Mental Health Center 10710 Old Highway 64 Bolivar TN 38008-3587 Ph: (731) 658-6113 | Quinco Mental Health Center 10710 Old Highway 64 Bolivar TN 38008-3587 Ph: (731) 658-6113 |
| NPI Number | 1255442794 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 04/02/2019 |
| Medicare PECOS PAC ID | 3678475621 |
|---|---|
| Medicare Enrollment ID | O20040121001005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255442794 | NPI | - | NPPES |
| 3706936 | Medicaid | TN | |
| 2008479 | Other | TN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | L 214-076-6309 (Tennessee) | Primary |
| 343900000X | Non-emergency Medical Transport (van) | (* (Not Available)) | Secondary |
| Provider Name | Patricia Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235331323 PECOS PAC ID: 4385736768 Enrollment ID: I20070815000898 |
| Provider Name | Leslie Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851591317 PECOS PAC ID: 2860582459 Enrollment ID: I20071219000702 |
| Provider Name | Catherine M Greene |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629176953 PECOS PAC ID: 5496825788 Enrollment ID: I20080529000215 |
| Provider Name | Kimba J Keel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043427982 PECOS PAC ID: 0042379463 Enrollment ID: I20081030000156 |
| Provider Name | Stacie K Grantham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215175278 PECOS PAC ID: 2567510423 Enrollment ID: I20090501000505 |
| Provider Name | Lindsay Hutchinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609957661 PECOS PAC ID: 1456401801 Enrollment ID: I20090608000017 |
| Provider Name | Catherine A White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538173901 PECOS PAC ID: 1254463680 Enrollment ID: I20100720000489 |
| Provider Name | Brian White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821106725 PECOS PAC ID: 6901939131 Enrollment ID: I20100809000407 |
| Provider Name | Lashon Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134438062 PECOS PAC ID: 9133318785 Enrollment ID: I20110112000772 |
| Provider Name | Amber Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447292438 PECOS PAC ID: 2567452097 Enrollment ID: I20130108000233 |
| Provider Name | Kathy C Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093054538 PECOS PAC ID: 1557501202 Enrollment ID: I20130701000648 |
| Provider Name | Melissa Cherry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417092511 PECOS PAC ID: 6002102555 Enrollment ID: I20160908002359 |
| Provider Name | Kimberly Fowler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831245166 PECOS PAC ID: 3476803461 Enrollment ID: I20180912003741 |
| Provider Name | Markeshe Brashund Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184127276 PECOS PAC ID: 4688928385 Enrollment ID: I20181115002251 |
| Provider Name | Merry Anna Snider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578101499 PECOS PAC ID: 1850720962 Enrollment ID: I20200410000045 |
| Provider Name | Lindsey Hendrix Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245864685 PECOS PAC ID: 7810328788 Enrollment ID: I20200508000391 |
| Provider Name | Dongmo Georgette Tekobo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821753906 PECOS PAC ID: 9537538764 Enrollment ID: I20221212000444 |
| Provider Name | Tynetta Qunique Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003530098 PECOS PAC ID: 0446620496 Enrollment ID: I20230109000312 |
| Provider Name | Wanda M Woodward |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861707762 PECOS PAC ID: 4183072622 Enrollment ID: I20231122001446 |
| Provider Name | Stephanie Goodrum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972611788 PECOS PAC ID: 4486002425 Enrollment ID: I20231130003064 |
| Provider Name | Coleman Jeff Helton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689783482 PECOS PAC ID: 7315398161 Enrollment ID: I20240105003356 |
| Provider Name | Rebecca Holloway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891312591 PECOS PAC ID: 6002268646 Enrollment ID: I20240118003238 |
Springfield Neurology Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 107 Tennessee St, Bolivar, TN 38008 Phone: 615-384-2411 | |
Brown Behavioral Health Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 623 Moss Ln, Bolivar, TN 38008 Phone: 901-864-9563 |