Healthcare Provider Details

I. General information

NPI: 1285554824
Provider Name (Legal Business Name): NEXTPHASE COUNSELING & WELLNESS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3982 WANDERING WAY
MEMPHIS TN
38115-6526
US

IV. Provider business mailing address

3982 WANDERING WAY
MEMPHIS TN
38115-6526
US

V. Phone/Fax

Practice location:
  • Phone: 662-804-3363
  • Fax:
Mailing address:
  • Phone: 662-804-3363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: BEVRON TEMPLE
Title or Position: PRES/CEO
Credential:
Phone: 662-804-3363