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General NPI Number Information
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NPI Number | 1881054625
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Entity Type | Individual
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Provider Name | NAKEESHA LONGMIRE LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 1698 BELLEDEER DR E
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City | CORDOVA
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State | TN
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Zip | 38016-0428
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Country | US
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Telephone | 901-292-6928
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 UNION AVE STE 1024
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City | MEMPHIS
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State | TN
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Zip | 38104-7509
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Country | US
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Telephone | 901-833-7095
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 10786
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License Number State | TN
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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 | 6764
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License Number State | TN
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