Healthcare Provider Details

I. General information

NPI: 1215828017
Provider Name (Legal Business Name): JESSE ABELL MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 S AUBURNDALE ST
MEMPHIS TN
38104-3916
US

IV. Provider business mailing address

35 S AUBURNDALE ST
MEMPHIS TN
38104-3916
US

V. Phone/Fax

Practice location:
  • Phone: 901-729-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16237
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: