Healthcare Provider Details

I. General information

NPI: 1225137995
Provider Name (Legal Business Name): MIDTOWN COUNSELING CTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 UNION AVENUE STE 101
MEMPHIS TN
38104
US

IV. Provider business mailing address

1835 UNION AVENUE STE 101
MEMPHIS TN
38104
US

V. Phone/Fax

Practice location:
  • Phone: 901-726-4586
  • Fax: 901-272-8782
Mailing address:
  • Phone: 901-726-4586
  • Fax: 901-272-8782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARTHA ANN FERGUSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 901-726-4586