Reform Psychiatry Llc | |
433 Nissan Dr Ste 301 Smyrna TN 37167 | |
(615) 751-0347 | |
(615) 249-5162 |
Full Name | Reform Psychiatry Llc |
---|---|
Speciality | Clinic/Center |
Location | 433 Nissan Dr Ste 301, Smyrna, Tennessee |
Authorized Official Name and Position | Jemima Mensah (OWNER) |
Authorized Official Contact | 2075300461 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Reform Psychiatry Llc 433 Nissan Dr Ste 301 Smyrna TN 37167-4360 Ph: (615) 751-0347 | Reform Psychiatry Llc 433 Nissan Dr Ste 301 Smyrna TN 37167 Ph: (615) 751-0347 |
NPI Number | 1417510363 |
---|---|
Provider Enumeration Date | 04/16/2019 |
Last Update Date | 07/01/2019 |
Medicare PECOS PAC ID | 5597095091 |
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Medicare Enrollment ID | O20190926000493 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417510363 | NPI | - | NPPES |
Q049227 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Jemima Mensah |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659834455 PECOS PAC ID: 6406186907 Enrollment ID: I20190926000616 |
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