| Imani Behavioral Health, Pllc | |
|
93 Beaumont St Clarksville TN 37040-3217 | |
| (931) 919-2686 | |
| Not Available |
| Full Name | Imani Behavioral Health, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 93 Beaumont St, Clarksville, Tennessee |
| Authorized Official Name and Position | Jeremy Lynch (MEMBER) |
| Authorized Official Contact | 6156698372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imani Behavioral Health, Pllc 93 Beaumont St Clarksville TN 37040-3217 Ph: (931) 919-2686 | Imani Behavioral Health, Pllc 93 Beaumont St Clarksville TN 37040-3217 Ph: (931) 919-2686 |
| NPI Number | 1992294102 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Medicare PECOS PAC ID | 9739581588 |
|---|---|
| Medicare Enrollment ID | O20210715002683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992294102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Robert T Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861492290 PECOS PAC ID: 3971558370 Enrollment ID: I20210729002596 |
| Provider Name | Tiffany Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376819045 PECOS PAC ID: 6002219813 Enrollment ID: I20210730000467 |
| Provider Name | Tamara Boone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245729284 PECOS PAC ID: 5799140653 Enrollment ID: I20240417001177 |
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