DENISE LANDAU


Address: 4646 Poplar Ave Ste 217, Memphis, TN 38117-4432
Phone: 9016525344

DENISE LANDAU (NPI# 1841363827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841363827
Entity Type Individual
Full Name DENISE LANDAU
Credential PHD
Practice Address 4646 Poplar Ave Ste 217
Memphis
TN 38117-4432
Mailing Address Po Box 341104
Bartlett
TN 38184-1104
Practice Telephone 9016525344
Practice Fax Number 8884186339
Mailing Telephone 9016525344
Mailing Fax Number 8884186339
Enumeration Date 2006-11-16
Last Update Date 2015-11-05
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
P1212 TN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
TN BLUE CROSS BLUE SHIELD 3071776 01

Office Location

Street Address 4646 POPLAR AVE STE 217
City MEMPHIS
State TN
Zip Code 38117-4432

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1023547494 Rivka R Braverman Licensed Practical Nurse 5050 Sanderlin Avenue, Memphis, TN 38117 2017-06-08
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447805031 Jasmine Jones Psychologist 516 Tennessee St Ste 225, Memphis, TN 38103-4717 2019-08-09
1649768870 River City Neuropsychology, Pllc Psychologist 1661 International Dr., Suite 400, Memphis, TN 38120 2018-04-24
1265950919 Memphis Center for Mindful Living, LLC Psychologist 4646 Poplar Ave Ste 435, Memphis, TN 38117-4443 2017-09-01
1053869354 Kimberly Noel Fleming Psychologist 512 Alexander St, Memphis, TN 38111-4310 2016-09-14
1003230350 Kyong Han Psychologist 6401 Poplar Ave Ste 420, Memphis, TN 38119-4806 2014-02-06
1578997615 William Leslie Fulliton Psychologist 1407 Union Ave Ste 1407, Memphis, TN 38104 2013-08-26
1073862827 Joann Paula Raby Psychologist 5119 Summer Ave Ste 233, Memphis, TN 38122-4417 2012-09-06
1922236546 Robert Allen Neimeyer Psychologist Department of Psychology 400 Innovation Dr, University of Memphis, Memphis, TN 38152-3230 2009-06-23
1477753564 Meghan Eileen Mcdevitt-murphy Psychologist 202 Psychology Bldg, University of Memphis, Memphis, TN 38152-3230 2007-07-18
1508086976 Charlotte L Kennedy Psychologist 4953 W Old Farm Rd, Memphis, TN 38125-3706 2007-04-26
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Competitor

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City MEMPHIS
Zip Code 38117

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Dataset Information

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.

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