| Christian Psychological Center, Inc. | |
|
3950 Central Ave Memphis TN 38111-7602 | |
| (901) 458-6291 | |
| (901) 323-4848 |
| Full Name | Christian Psychological Center, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 3950 Central Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Tonia L Long (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9014586291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christian Psychological Center, Inc. 3950 Central Ave Memphis TN 38111-7602 Ph: (901) 458-6291 | Christian Psychological Center, Inc. 3950 Central Ave Memphis TN 38111-7602 Ph: (901) 458-6291 |
| NPI Number | 1184625006 |
|---|---|
| Provider Enumeration Date | 08/02/2005 |
| Last Update Date | 08/21/2012 |
| Medicare PECOS PAC ID | 6305867763 |
|---|---|
| Medicare Enrollment ID | O20150423001187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184625006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (Tennessee) | Secondary |
| 103T00000X | Psychologist | (Tennessee) | Primary |
| 1041C0700X | Social Worker - Clinical | (Tennessee) | Secondary |
| Provider Name | Douglas J Hart |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790785723 PECOS PAC ID: 3870515364 Enrollment ID: I20051227000629 |
| Provider Name | Brent E Stenberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427058494 PECOS PAC ID: 2668494378 Enrollment ID: I20051228000039 |
| Provider Name | Paul J Neal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265433296 PECOS PAC ID: 0042384307 Enrollment ID: I20080805000041 |
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