Healthcare Provider Details

I. General information

NPI: 1134940323
Provider Name (Legal Business Name): URBAN COMMUNITY MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 SAINT PAUL AVE
MEMPHIS TN
38126-3503
US

IV. Provider business mailing address

715 SAINT PAUL AVE
MEMPHIS TN
38126-3503
US

V. Phone/Fax

Practice location:
  • Phone: 901-577-0929
  • Fax:
Mailing address:
  • Phone: 901-577-0929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DONNA WALKER
Title or Position: DIRECTOR
Credential: LPC-MHSP, NCC
Phone: 901-692-6012