| Pennie S Heath Lcsw Llc | |
|
131 N Tucker St Memphis TN 38104-2636 | |
| (901) 726-5600 | |
| (865) 246-2106 |
| Full Name | Pennie S Heath Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 131 N Tucker St, Memphis, Tennessee |
| Authorized Official Name and Position | Pennie S Heath (OWNER) |
| Authorized Official Contact | 8652462104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennie S Heath Lcsw Llc Po Box 5777 Maryville TN 37802-5777 Ph: (865) 246-2104 | Pennie S Heath Lcsw Llc 131 N Tucker St Memphis TN 38104-2636 Ph: (901) 726-5600 |
| NPI Number | 1568948792 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 07/11/2018 |
| Medicare PECOS PAC ID | 8921352428 |
|---|---|
| Medicare Enrollment ID | O20181120001846 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568948792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Pennie S Heath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033392410 PECOS PAC ID: 5799865648 Enrollment ID: I20080103000702 |
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