Individual provider Active NPI

Audrey Lindale Townsel, PSYD

  • Psychologist
  • Memphis, TN
National Provider Identifier
1043352479
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3010 Issued in TN
Practice address
4646 Poplar Ave Ste 412
Memphis, TN 38117
Phone
(901) 413-8663
Fax
(901) 618-2325
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 3010 TN Primary

Addresses

Primary practice location

4646 Poplar Ave Ste 412
Memphis, TN 38117

Mailing address

PO Box 4071
Cordova, TN 38088-4071
Phone (901) 413-8663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3010TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Integrated Living Inc CurrentSince Nov 9, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1043352479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4071",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380884071",
            "telephone_number": "901-413-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 POPLAR AVE STE 412",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-413-8663",
            "fax_number": "901-618-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSEL",
        "first_name": "AUDREY",
        "middle_name": "LINDALE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.