Customized Veterans Group

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

CUSTOMIZED VETERANS GROUP

Practice address

578 Harrell St
Memphis, TN 38112-2932

Phone

(901) 907-0640

Fax

(901) 255-0758

NPI assigned

Jan 14, 2025

Organization subpart

No

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

Authorized official

Name

Antwane Bohanon

Title

Chief Executive Officer

Phone

(808) 453-0018

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christi Davidson, LIFESTYLE COACH

  • Health & Wellness Coach
  • Memphis, TN
  • NPI 1063237113

  Multi-Specialty

  NPD
• Terry Hill, LC

  • Health & Wellness Coach
  • Memphis, TN
  • NPI 1609696863

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1184435802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 HARRELL ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122932",
            "telephone_number": "901-907-0640",
            "fax_number": "901-255-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 HARRELL ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122932",
            "telephone_number": "901-907-0640",
            "fax_number": "901-255-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMIZED VETERANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "BOHANON",
        "authorized_official_first_name": "ANTWANE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-453-0018"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sudie Cushman, M.E.D
• William Chandler Cushman, MD
• Customized Medical Needs
• Customized Medical Needs
• Customized Medical Needs
• Nicholas Alan Cutter, PT, DPT
• Teresa F. Cutts, PH.D.
• Cworld Healthcare
• Cynthia Coleman Job Coaching Service
• Cynthia'S Happy Home Care LLC

• Addiction (Substance Use Disorder) Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.