Healthcare Provider Details

I. General information

NPI: 1043668999
Provider Name (Legal Business Name): LEAH BEARMAN PINKSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH DOROTHY BEARMAN

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 CENTERVIEW PKWY STE 103
CORDOVA TN
38018-4264
US

IV. Provider business mailing address

601 S FOREST ST APT 319
GLENDALE CO
80246-1645
US

V. Phone/Fax

Practice location:
  • Phone: 901-417-7434
  • Fax:
Mailing address:
  • Phone: 901-258-1332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4372
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: