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General NPI Number Information
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NPI Number | 1184430571
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Entity Type | Organization
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Legal Business Name | MANE UP MEMPHIS
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 622 MINOR ST
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City | MEMPHIS
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State | TN
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Zip | 38111-5808
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Country | US
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Telephone | 901-290-7226
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Fax |
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Provider Business Mailing Address
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Address Line | 5041 CHERRY BARK CV
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City | MEMPHIS
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State | TN
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Zip | 38141-8418
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Country | US
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Telephone | 901-395-4458
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RACHEAL WALKER
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Credential |
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Telephone | 901-395-4458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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