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General NPI Number Information
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NPI Number | 1457936114
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Entity Type | Organization
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Legal Business Name | SWEETGRASS COUNSELING & CONSULTATION, LLC
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 4095 AMERICAN WAY STE 10
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City | MEMPHIS
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State | TN
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Zip | 38118-8339
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Country | US
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Telephone | 901-245-3220
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Fax | 901-370-3265
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Provider Business Mailing Address
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Address Line | 10640 BIRD STONE CV
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City | CORDOVA
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State | TN
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Zip | 38016-5561
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Country | US
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Telephone | 901-500-5899
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Fax | 901-370-3265
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Authorized Official
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Title or Position | CO-OWNER
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Name | SHANEIKA SMITH
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Credential | PHD
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Telephone | 901-800-6595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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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