| Jennifer Petell, PHD IN CLINICAL PSY | |
|
5908 Getwell Rd, Southaven, MS 38672-7317 | |
| (901) 536-4646 | |
| (662) 536-4443 |
| Full Name | Jennifer Petell |
|---|---|
| Gender | Female |
| Speciality | Psychologist |
| Location | 5908 Getwell Rd, Southaven, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710505268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 641185 (Mississippi) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 4107 (Tennessee) | Secondary |
| Entity Name | Primary Care Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093016651 PECOS PAC ID: 0941480131 Enrollment ID: O20110920000312 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Petell, PHD IN CLINICAL PSY 1211 Union Ave Ste 330, Memphis, TN 38104-6655 Ph: () - | Jennifer Petell, PHD IN CLINICAL PSY 5908 Getwell Rd, Southaven, MS 38672-7317 Ph: (901) 536-4646 |
Dr. Patricia Michele Wright, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5627 Getwell Rd, Bldg B, Ste 4, Southaven, MS 38672 Phone: 662-349-2979 Fax: 662-349-2978 | |
Sarah Irby, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5960 Getwell Rd Ste 212d, Southaven, MS 38672 Phone: 662-228-0130 Fax: 678-868-2843 | |
Olivia Chonte King Deberry, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2103 Ansley Park Ln, Southaven, MS 38672 Phone: 901-240-2955 | |
Dr. Dominik Lia Keller, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5915 Getwell Rd Bldg B, Southaven, MS 38672 Phone: 662-349-2979 | |
Dr. Shirley Ann Wilson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7165 B Swinnea, Ste 1, Southaven, MS 38671 Phone: 662-349-6658 Fax: 662-349-6856 | |
Dr. Paul Sheldon Leonard, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 7075 Golden Oaks Loop W, Southaven, MS 38671 Phone: 901-485-1848 Fax: 662-349-3988 |