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General NPI Number Information
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NPI Number | 1891503876
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Entity Type | Organization
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Legal Business Name | WEST TN FAMILY & CRISIS SERVICES CENTER LLC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 825 BERCLAIR RD APT 8
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City | MEMPHIS
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State | TN
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Zip | 38122-5404
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Country | US
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Telephone | 901-206-6250
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Fax |
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Provider Business Mailing Address
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Address Line | 116 AGNES RD STE 200
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City | KNOXVILLE
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State | TN
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Zip | 37919-6306
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Country | US
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Telephone | 901-206-6250
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Fax |
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Authorized Official
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Title or Position | CEO-CLINICAL FORENSIC SOCIAL WORKER
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Name | PROF. ADRIAN DEWAYNE SOLOMON
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Credential | LCSW,MSSW, MHRT
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Telephone | 901-206-6250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0812X
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Taxonomy Name | Community Psychiatric/Mental Health Clinical Nurse Specialist
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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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