E3 Community Health/ Engage. Educate. Empower. Community Health

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

E3 COMMUNITY HEALTH/ ENGAGE. EDUCATE. EMPOWER. COMMUNITY HEALTH

Doing business as

E3 Community Health/ Engage. Educate. Empower. Community Health

Practice address

5587 Murray Ave Ste 205
Memphis, TN 38119-0896

Phone

(901) 729-9767

NPI assigned

Jun 20, 2019

Organization subpart

No

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

Authorized official

Name

Brisa Samudio, LCSWNPI 1366752347

Title

Managing Member

Phone

(901) 729-9767

Specialties & licenses 3

Addresses

Other names 1

• E3 Community Health/ Engage. Educate. Empower. Community Health Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Brisa S Samudio, LCSW

  • Mental Health Counselor
  • Memphis, TN
  • NPI 1366752347
  NPD Authorized official

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1366002305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5587 MURRAY AVE STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190896",
            "telephone_number": "901-729-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5587 MURRAY AVE STE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190896",
            "telephone_number": "901-729-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E3 COMMUNITY HEALTH/ ENGAGE. EDUCATE. EMPOWER. COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "SAMUDIO",
        "authorized_official_first_name": "BRISA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "901-729-9767",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant patient portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5587 Murray Ave Ste 205",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381190896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "E3 Community Health/ Engage. Educate. Empower. Community Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Memphis, TN
• Providers in Memphis, TN by specialty
• Community/Behavioral Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.