MEDICARE: PEACE OF MIND MENTAL HEALTH AND WELLNESS CENTER 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1467225854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE OF MIND MENTAL HEALTH AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	5885 RIDGEWAY CENTER PKWY STE 102
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-4011
Country	:	US
Telephone Number	:	901-410-2090
Fax Number	:	901-410-2251

Provider Business Practice Location Address
First Line	:	5885 RIDGEWAY CENTER PKWY STE 102
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-4011
Country	:	US
Telephone Number	:	901-410-2090
Fax Number	:	901-410-2251

Authorized Official
Title or Position	:	CEO
Name	:	MRS. LATASHA SHERE GARRETT
Credential	:	PMHNP-BC
Telephone Number	:	901-410-2090

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	07/27/2025

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