| Step Up Care Of Tennessee Llc | |
|
1250 Farrow Rd Memphis TN 38116-7116 | |
| (718) 298-4375 | |
| Not Available |
| Full Name | Step Up Care Of Tennessee Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1250 Farrow Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Raphael Lichtschein (OWNER) |
| Authorized Official Contact | 7185061115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Step Up Care Of Tennessee Llc 27 Randolph Rd Howell NJ 07731-8611 Ph: (718) 298-4375 | Step Up Care Of Tennessee Llc 1250 Farrow Rd Memphis TN 38116-7116 Ph: (718) 298-4375 |
| NPI Number | 1023660206 |
|---|---|
| Provider Enumeration Date | 07/09/2019 |
| Last Update Date | 07/09/2019 |
| Medicare PECOS PAC ID | 5395074728 |
|---|---|
| Medicare Enrollment ID | O20190911000795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023660206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Myra Y Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699838508 PECOS PAC ID: 1658474648 Enrollment ID: I20070312000586 |
| Provider Name | Brian Billings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194996264 PECOS PAC ID: 2466514518 Enrollment ID: I20081223000644 |
| Provider Name | Melynie M Cagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669800157 PECOS PAC ID: 0345476347 Enrollment ID: I20131121001764 |
| Provider Name | Jakeisha Taylor Goston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710381264 PECOS PAC ID: 0143442210 Enrollment ID: I20141105002651 |
| Provider Name | Shirley S Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093108052 PECOS PAC ID: 1456660042 Enrollment ID: I20151021003269 |
| Provider Name | Mitzie Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760722284 PECOS PAC ID: 5294959615 Enrollment ID: I20160225001559 |
| Provider Name | Cheryl S Richmond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871544973 PECOS PAC ID: 6709977168 Enrollment ID: I20161109000127 |
| Provider Name | Mary E Hamm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023552387 PECOS PAC ID: 7315220795 Enrollment ID: I20170208003129 |
| Provider Name | Indria Clay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649315201 PECOS PAC ID: 2264666270 Enrollment ID: I20171011001264 |
| Provider Name | Natalie M Stamey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306868393 PECOS PAC ID: 4587663315 Enrollment ID: I20190723001067 |
| Provider Name | Tammie A Kampa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528623162 PECOS PAC ID: 2860722436 Enrollment ID: I20190924003021 |
| Provider Name | Leon K Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982828158 PECOS PAC ID: 9638501950 Enrollment ID: I20191107000349 |
| Provider Name | Alison J Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528662517 PECOS PAC ID: 5991119588 Enrollment ID: I20210121002115 |
| Provider Name | Kathleen Engel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235640863 PECOS PAC ID: 5698181998 Enrollment ID: I20210311001252 |
| Provider Name | Karen Milliner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306412937 PECOS PAC ID: 9739589045 Enrollment ID: I20210608001917 |
| Provider Name | Lajoya Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932581386 PECOS PAC ID: 7517368939 Enrollment ID: I20210630000070 |
| Provider Name | Avanti Cross-brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144846767 PECOS PAC ID: 6002219607 Enrollment ID: I20210720001879 |
| Provider Name | Kelley Catherine Lewin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851777270 PECOS PAC ID: 4688078231 Enrollment ID: I20210804003056 |
| Provider Name | Karen Y Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225654726 PECOS PAC ID: 8426447251 Enrollment ID: I20211116001305 |
| Provider Name | Alexandra K Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245531987 PECOS PAC ID: 3971779091 Enrollment ID: I20211119002525 |
| Provider Name | Marilyn D Haymaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669720587 PECOS PAC ID: 3274924774 Enrollment ID: I20211216001663 |
| Provider Name | Lisa Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639535545 PECOS PAC ID: 5092063768 Enrollment ID: I20220112001287 |
| Provider Name | Arnzie A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306269808 PECOS PAC ID: 9638562457 Enrollment ID: I20220131000789 |
| Provider Name | Lauren T Hudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619630217 PECOS PAC ID: 1153715305 Enrollment ID: I20220303001917 |
| Provider Name | Jodi E Essary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699414946 PECOS PAC ID: 5991184160 Enrollment ID: I20220617000879 |
| Provider Name | Jamil E Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922771468 PECOS PAC ID: 3375923030 Enrollment ID: I20220712001788 |
| Provider Name | Mary Jean Bufford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336875038 PECOS PAC ID: 6709268725 Enrollment ID: I20220807000100 |
| Provider Name | Chelsey Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346821097 PECOS PAC ID: 9638542111 Enrollment ID: I20230303000151 |
| Provider Name | Kimberly H Dafferner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427698323 PECOS PAC ID: 7012374226 Enrollment ID: I20230602001697 |
| Provider Name | Abigail Ewing Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881472215 PECOS PAC ID: 3375997869 Enrollment ID: I20231003001040 |
| Provider Name | Jennifer Denise Monnette |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295387819 PECOS PAC ID: 8325490568 Enrollment ID: I20240123004022 |
| Provider Name | Samantha Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386332229 PECOS PAC ID: 2567806102 Enrollment ID: I20240222000203 |
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