MEDICARE: SWEETGRASS COUNSELING & CONSULTATION, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1457936114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEETGRASS COUNSELING & CONSULTATION, LLC

Provider Business Mailing Address
First Line	:	10640 BIRD STONE CV
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-5561
Country	:	US
Telephone Number	:	901-500-5899
Fax Number	:	901-370-3265

Provider Business Practice Location Address
First Line	:	2899 S MENDENHALL RD STE 1
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2247
Country	:	US
Telephone Number	:	901-245-3220
Fax Number	:	901-370-3265

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. SHANEIKA SMITH
Credential	:	LPC-MHSP
Telephone Number	:	901-500-6899

Provider Enumeration Date	:	03/15/2021
Last Update Date	:	06/01/2026

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