Healthcare Provider Details

I. General information

NPI: 1508600149
Provider Name (Legal Business Name): ENJOYCO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 WESTGATE CIR STE 240
BRENTWOOD TN
37027-8578
US

IV. Provider business mailing address

1604 WESTGATE CIR STE 240
BRENTWOOD TN
37027-8578
US

V. Phone/Fax

Practice location:
  • Phone: 410-562-1365
  • Fax:
Mailing address:
  • Phone: 410-562-1365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CARLY M. SAMUDRE
Title or Position: CO-OWNER
Credential: LPC-MHSP
Phone: 410-562-1365