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General NPI Number Information
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NPI Number | 1427093798
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING & MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 2920 HIGHWAY 641 N
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City | PARIS
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State | TN
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Zip | 38242-8832
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Country | US
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Telephone | 731-642-3600
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Fax | 731-642-6037
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Provider Business Mailing Address
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Address Line | 230-B TYSON AVENUE BOX 132
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City | PARIS
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State | TN
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Zip | 38242-0132
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Country | US
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Telephone | 731-642-3600
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Fax | 731-642-6037
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Authorized Official
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Title or Position | OWNER
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Name | SHERRY LYNN DOCKINS-PRITCHETT
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Credential | LCSW
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Telephone | 731-642-3600
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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 | 3962
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License Number State | TN
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