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General NPI Number Information
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NPI Number | 1144895400
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Entity Type | Individual
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Provider Name | JUSTIN GARRETT PRICE LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 6401 POPLAR AVE STE 500
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City | MEMPHIS
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State | TN
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Zip | 38119-4808
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Country | US
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Telephone | 901-472-4293
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-3475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13766
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License Number State | TN
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