| Odessa A. Williamson | |
|
694 Williams St. Memphis TN 38126 | |
| (901) 947-2136 | |
| (901) 947-6680 |
| Full Name | Odessa A. Williamson |
|---|---|
| Speciality | Social Worker |
| Location | 694 Williams St., Memphis, Tennessee |
| Authorized Official Name and Position | Odessa Ann Williamson (OWNER) |
| Authorized Official Contact | 9019472136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Odessa A. Williamson 694 Williams St. Memphis TN 38126 Ph: (901) 947-2136 | Odessa A. Williamson 694 Williams St. Memphis TN 38126 Ph: (901) 947-2136 |
| NPI Number | 1427287184 |
|---|---|
| Provider Enumeration Date | 07/02/2009 |
| Last Update Date | 07/02/2009 |
| Medicare PECOS PAC ID | 5991847592 |
|---|---|
| Medicare Enrollment ID | O20100120000439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427287184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LSW0000004677 (Tennessee) | Primary |
| Provider Name | Tanci Burrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851482921 PECOS PAC ID: 4486722618 Enrollment ID: I20081001000319 |
| 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 | Michael Valdes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841544178 PECOS PAC ID: 2961829254 Enrollment ID: I20200901002574 |
| Provider Name | Shirley Renee Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841885449 PECOS PAC ID: 9537578117 Enrollment ID: I20210512000066 |
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