LILLIE MATLOCK (NPI# 1790170140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790170140 |
| Entity Type | Individual |
| Full Name | LILLIE MATLOCK |
| Practice Address |
315 Dr Martin Luther King Dr Memphis TN 38104 |
| Practice Telephone | 9018270571 |
| Practice Fax Number | 8005945717 |
| Mailing Telephone | 9018270571 |
| Mailing Fax Number | 8005945717 |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers |
| Street Address |
315 DR MARTIN LUTHER KING DR |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174918502 | Janet Malone | Counselor | 315 Dr Martin Luther King Dr, Memphis, TN 38104 | 2015-04-02 |
| 1114312550 | Shirley Jones | Counselor | 315 Dr Martin Luther King Dr, Memphis, TN 38104 | 2015-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 101YP1600X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Pastoral |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851825590 | Charliss Mcmorris | Counselor | 2735 S Mendenhall Rd, Suite 8, Memphis, TN 38115-1556 | 2017-04-19 |
| 1508082843 | Lenn Harris Milam | Counselor | 1565 Overton Park Ave, Memphis, TN 38112-5136 | 2007-04-17 |
| 1942640982 | Janet Schaller | Counselor | 35 S Auburndale St, Memphis, TN 38104-3916 | 2013-07-03 |
| 1811213648 | Anita Harris | Counselor | 3810 Winchester Rd, Southeast Mhc, Memphis, TN 38118-6045 | 2010-04-19 |
| 1790901171 | Myra Lyn Bennett | Counselor | 5350 Poplar Ave Ste 730, Memphis, TN 38119-3697 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073168266 | Tresie Menise Lopez | Counselor | 366 New Byhalia Rd Ste 3a, Collierville, TN 38017-3718 | 2019-08-05 |
| 1578027728 | Jason Devon Milam | Counselor | 4277 Sandstone Dr, Antioch, TN 37013-2259 | 2019-01-22 |
| 1851808455 | David Spencer Thornton | Counselor | 7003 Chadwick Dr Ste 232, Brentwood, TN 37027-3224 | 2018-01-04 |
| 1780115782 | Brian Hooper | Counselor | 4525 Harding Road, Suite 221, Nashville, TN 37205-2119 | 2017-03-22 |
| 1558730903 | Clay Evans Boyd IIi | Counselor | 302 Sunset Dr Ste 103, Johnson City, TN 37604-2408 | 2015-09-16 |
| 1346625258 | Grief Aftercare Program | Counselor | 2501 Clarksville Pike, Suite 2517, Nashville, TN 37208-1059 | 2015-07-22 |
| 1477947026 | Desdamona Butler | Counselor | 1604 Westgate Cir Ste 240, Brentwood, TN 37027-8578 | 2015-03-21 |
| 1205226313 | Pamela Denise Poteat | Counselor | 333 Fann Rd, Nolensville, TN 37135 | 2015-01-27 |
| 1891183174 | Catherine Denise Kirkland | Counselor | 2670 Memorial Blvd Ste F, Murfreesboro, TN 37129-5134 | 2015-01-08 |
| 1285974246 | Yolanda Anjnette Robinson | Counselor | 111 Center Park Dr Ste 115, Knoxville, TN 37922-2121 | 2013-02-27 |
| Find all providers with the same taxonomy | ||||
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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.