| Guiding Star Mental Health | |
|
817 Westcott Ln Antioch TN 37013-5272 | |
| (615) 243-0968 | |
| Not Available |
| Full Name | Guiding Star Mental Health |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 817 Westcott Ln, Antioch, Tennessee |
| Authorized Official Name and Position | Boulos Saad (SOLE MEMBER) |
| Authorized Official Contact | 6152430968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guiding Star Mental Health 817 Westcott Ln Antioch TN 37013-5272 Ph: (615) 243-0968 | Guiding Star Mental Health 817 Westcott Ln Antioch TN 37013-5272 Ph: (615) 243-0968 |
| NPI Number | 1518716414 |
|---|---|
| Provider Enumeration Date | 05/14/2024 |
| Last Update Date | 09/17/2024 |
| Certification Date | 09/17/2024 |
| Medicare PECOS PAC ID | 1850825720 |
|---|---|
| Medicare Enrollment ID | O20241114002167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518716414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Melanie M Daugherty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952430571 PECOS PAC ID: 5496781304 Enrollment ID: I20050712000989 |
| Provider Name | Jaye Bilyeu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982920021 PECOS PAC ID: 1153855028 Enrollment ID: I20241114002462 |
| Provider Name | Tyra Watts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720422371 PECOS PAC ID: 7315388014 Enrollment ID: I20241115001631 |
| Provider Name | Jennifer Washburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073340410 PECOS PAC ID: 9234664624 Enrollment ID: I20241121003406 |
| Provider Name | Amy Holt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821825969 PECOS PAC ID: 5294261202 Enrollment ID: I20241212004178 |
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