NPIMap

Organization Active NPI

Christian Psychological Center, Inc.

  • Psychologist
  • Memphis, TN
National Provider Identifier
1184625006
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CHRISTIAN PSYCHOLOGICAL CENTER, INC.
Practice address
3950 Central Ave
Memphis, TN 38111-7602
Phone
(901) 458-6291
Fax
(901) 323-4848
NPI assigned
Aug 2, 2005
Last updated
Aug 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Authorized official

Name
Tonia L Long, PH.D.NPI 1396745329
Title
Clinical Psychologist
Phone
(901) 458-6291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X TN
Psychologist 103T00000X TN Primary
Clinical Social Worker 1041C0700X TN

Addresses

Primary practice location

3950 Central Ave
Memphis, TN 38111-7602

Mailing address

3950 Central Ave
Memphis, TN 38111-7602
Phone (901) 458-6291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150423001187 TN Part B Supplier - Clinic/Group Practice 6305867763 Receives reassigned benefits from 4 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

3950 Central Ave
Memphis, TN 38111
Phone (901) 458-6291

3978 Central Ave
Memphis, TN 38111
Phone (901) 458-6291

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1184625006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 CENTRAL AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381117602",
            "telephone_number": "901-458-6291",
            "fax_number": "901-323-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 CENTRAL AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381117602",
            "telephone_number": "901-458-6291",
            "fax_number": "901-323-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN PSYCHOLOGICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "TONIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "901-458-6291",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.