Healthcare Provider Details

I. General information

NPI: 1881132405
Provider Name (Legal Business Name): NATASHA CHANNELLE REINHARDT MS, NCC, LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATASHA CHANNELLE JOHNSON LPC-MHSP

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 CRESTHAVEN RD STE 200
MEMPHIS TN
38119-3867
US

IV. Provider business mailing address

5759 ALEXANDRIA LN
SOUTHAVEN MS
38671-8427
US

V. Phone/Fax

Practice location:
  • Phone: 901-401-0210
  • Fax:
Mailing address:
  • Phone: 901-426-8211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2024011458
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH61511163
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5198
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: