MEDICARE: QUALITY CARE SUPPORT & COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1043897309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY CARE SUPPORT & COUNSELING LLC

Provider Business Mailing Address
First Line	:	3189 KIRBY WHITTEN RD STE 203A
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-2854
Country	:	US
Telephone Number	:	901-443-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	3189 KIRBY WHITTEN RD STE 203A
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38134-2854
Country	:	US
Telephone Number	:	901-443-5311
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TAMEKA GANT
Credential	:	LPC
Telephone Number	:	901-443-5311

Provider Enumeration Date	:	03/24/2021
Last Update Date	:	03/24/2021

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