PEDIATRIC ADOLESCENT CENTER (NPI# 1497956825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497956825 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ADOLESCENT CENTER |
| Practice Address |
882 Willow Tree Cir Ste 201 Cordova TN 38018-3118 |
| Practice Telephone | 9017573520 |
| Practice Fax Number | 9017373807 |
| Mailing Telephone | 9017573520 |
| Mailing Fax Number | 9017373807 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MELISSA RENEA HALL (FRONT DESK MANAGER) |
| Authorized Official Telephone | 9017573520 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 2676 | TN | Behavioral Health & Social Service Providers |
| Street Address |
882 WILLOW TREE CIR STE 201 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38018-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264428 | Shaquia Janai Harris | Behavior Technician | 1079 N Houston Levee Road, Cordova, TN 38018 | 2020-10-29 |
| 1366041493 | Cynthia Brantley | Behavior Technician | 1079 N Houston Levee Rd, Cordova, TN 38018 | 2020-10-20 |
| 1558901736 | At Home Physical Rehabilitation Group, LLC | Physical Therapy Assistant | 856 Willow Tree Circle, Cordova, TN 38018 | 2020-01-15 |
| 1538703038 | Scott Eric Balogh | Psychiatry & Neurology | 65 Germantown Court, Suite 203, Cordova, TN 38018 | 2019-10-29 |
| 1851871305 | Joanna H Fussell | Behavioral Analyst | 8066 Walnut Run Suite 102, Cordova, TN 38018 | 2018-08-15 |
| 1841736097 | A Guardian Care Group | Home Health | 10164 Green Moss, Cordova, TN 38018 | 2017-01-12 |
| 1497127146 | Functional Independence, Inc. | Home Health | 270 German Oak Dr., Memphis, TN 38018 | 2015-10-21 |
| 1679984363 | Tiffany Masters Redfern | Obstetrics & Gynecology | 521 Riveredge Dr W, Cordova, TN 38018 | 2014-05-15 |
| 1295073427 | Mitchell Wyman Alvarez | Optometrist | 2075 N. Germantown Pkwy, Memphis, TN 38018 | 2013-01-23 |
| 1578827531 | Chiung Feng Hsu | Dentist | 831 Timber Creek Dr #1, Cordova, TN 38018 | 2012-06-25 |
| Find all providers in zip 38018 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295163228 | Princess Coleman | Psychologist | 1539 Fox Trace Dr, Cordova, TN 38016-5706 | 2013-10-30 |
| 1154601862 | Mardi Michele Smith | Psychologist | 543 Javelin Cv, Cordova, TN 38018-7674 | 2011-08-25 |
| 1790927705 | Michael W Davidson | Psychologist | 154 Timber Creek Dr Ste 4, Cordova, TN 38018-4252 | 2009-04-06 |
| 1114079795 | Barbara T Henking | Psychologist | 8134 Country Village, #102, Cordova, TN 38016 | 2007-01-17 |
| 1710906466 | Carolyn C Martin | Psychologist | 8142 Country Village Dr # 102, Cordova, TN 38016-2029 | 2006-07-19 |
| 1427076991 | John Sherwood Leite | Psychologist | 8134 Country Village Dr, Suite 102, Cordova, TN 38016-2029 | 2006-07-17 |
| 1518983196 | Mary H Wanat | Psychologist | 8134 Country Village Drive, Suite 102, Cordova, TN 38018-2029 | 2006-07-15 |
| 1386671352 | Tracy Mckee Agostin | Psychologist | 8820 Trinity Rd Ste 202, Cordova, TN 38018-2735 | 2006-06-27 |
| 1750808713 | Dickens Psychological Services LLC | Psychologist | 150 Timber Creek Dr Ste 6, Cordova, TN 38018-4236 | 2017-08-29 |
| 1043639818 | Memphis Integral Neurofeedback Institute LLC | Psychologist | 758 Walnut Knoll Ln, Suite 101, Cordova, TN 38018-3112 | 2014-04-09 |
| Find all providers in CORDOVA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.