Spirit of Service Counseling & Wellness Center, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

LPC0000002198 Issued in TN

Legal business name

SPIRIT OF SERVICE COUNSELING & WELLNESS CENTER, LLC

Practice address

3568 Kearney Ave
Memphis, TN 38111-5743

Phone

(901) 550-7867

Fax

(901) 529-7139

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Mary Elizabeth Statum, LPC-MHSP

Title

Owner/Member

Phone

(901) 550-7867

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1386008753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3568 KEARNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381115743",
            "telephone_number": "901-550-7867",
            "fax_number": "901-529-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3568 KEARNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381115743",
            "telephone_number": "901-550-7867",
            "fax_number": "901-529-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT OF SERVICE COUNSELING & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "STATUM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "901-550-7867",
        "authorized_official_credential": "LPC-MHSP"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TN",
            "license": "LPC0000002198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki A. Spinosa, CMSW
• Michael Spinrad, MD
• Eugene J. Spiotta Jr., M.D.
• Larry B Spiotta, MD
• Spirit Health
• Spiritbuilders,Inc
• Hannah Elizabeth Dailey Spivey
• Hunter Spivey
• Patricia L Split, LCSW
• Caley Michelle Spotts, M.D.

• Point of Service in Memphis, TN
• Providers in Memphis, TN by specialty
• Point of Service in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.