Healthcare Provider Details

I. General information

NPI: 1699322958
Provider Name (Legal Business Name): SASHA NICOLE CORY LMFT, LCMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1779 KIRBY PKWY # 10307
MEMPHIS TN
38138-3666
US

IV. Provider business mailing address

1779 KIRBY PKWY # 10307
MEMPHIS TN
38138-3666
US

V. Phone/Fax

Practice location:
  • Phone: 615-933-9487
  • Fax:
Mailing address:
  • Phone: 615-933-9487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1589
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCM993
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: