Healthcare Provider Details

I. General information

NPI: 1891066106
Provider Name (Legal Business Name): ANIDE GERMEY FRANCIS-DUVAL LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 07/30/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 S COOPER ST STE 12&3
MEMPHIS TN
38104-5604
US

IV. Provider business mailing address

1317 ELKWOOD RD
MEMPHIS TN
38111-5447
US

V. Phone/Fax

Practice location:
  • Phone: 901-498-9126
  • Fax:
Mailing address:
  • Phone: 305-652-0771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5687
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: