| Clover Counseling Services Inc | |
|
6551 Stage Oaks Dr Ste 4 Bartlett TN 38134-3895 | |
| (901) 387-0026 | |
| (901) 552-4737 |
| Full Name | Clover Counseling Services Inc |
|---|---|
| Speciality | Counselor |
| Location | 6551 Stage Oaks Dr Ste 4, Bartlett, Tennessee |
| Authorized Official Name and Position | Kim Clover (PRESIDENT) |
| Authorized Official Contact | 9013870026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clover Counseling Services Inc 6551 Stage Oaks Dr Ste 4 Bartlett TN 38134-3895 Ph: (901) 387-0026 | Clover Counseling Services Inc 6551 Stage Oaks Dr Ste 4 Bartlett TN 38134-3895 Ph: (901) 387-0026 |
| NPI Number | 1265042253 |
|---|---|
| Provider Enumeration Date | 08/04/2020 |
| Last Update Date | 02/22/2022 |
| Certification Date | 02/22/2022 |
| Medicare PECOS PAC ID | 0749639912 |
|---|---|
| Medicare Enrollment ID | O20231213001491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265042253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Samantha N Hammonds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740615863 PECOS PAC ID: 4183999451 Enrollment ID: I20220729000775 |
| Provider Name | Suzanna Victoria Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437615507 PECOS PAC ID: 3173972346 Enrollment ID: I20231213001636 |
| Provider Name | Ashley Anne Tawfik |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710507637 PECOS PAC ID: 9830540293 Enrollment ID: I20240110001190 |
| Provider Name | Christy Marie Murphy |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1225553373 PECOS PAC ID: 5799136172 Enrollment ID: I20240110002174 |
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