Healthcare Provider Details

I. General information

NPI: 1861162992
Provider Name (Legal Business Name): ESTEEM COUNSELING AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3861 TAMARRON CIR APT 204
MEMPHIS TN
38125-2326
US

IV. Provider business mailing address

4933 FARMWOOD DR
MEMPHIS TN
38116-7911
US

V. Phone/Fax

Practice location:
  • Phone: 901-677-9888
  • Fax:
Mailing address:
  • Phone: 901-491-8469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERICA DAWKINS
Title or Position: OWNER
Credential:
Phone: 901-677-9888