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2523 Wilma Rudolph Blvd Clarksville TN 37040-5844 | |
| (931) 444-8355 | |
| (931) 443-9587 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2523 Wilma Rudolph Blvd, Clarksville, Tennessee |
| Authorized Official Name and Position | Tameka Mccullough (OWNER/COUNSELOR) |
| Authorized Official Contact | 9314448355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1565 Cedar Springs Cir Clarksville TN 37042-1579 Ph: (931) 241-9227 | 2523 Wilma Rudolph Blvd Clarksville TN 37040-5844 Ph: (931) 444-8355 |
| NPI Number | 1578347886 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 12/28/2024 |
| Certification Date | 12/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578347886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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