Organization Active NPI

Memphis Center for Women and Families

  • Clinical Psychologist
  • Memphis, TN
National Provider Identifier
1578894887
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MEMPHIS CENTER FOR WOMEN AND FAMILIES
Practice address
5154 Stage Rd
Ste 102
Memphis, TN 38134-3118
Phone
(901) 372-9133
Fax
(901) 372-1015
NPI assigned
Jan 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Authorized official

Name
Connie S Paul, PH.D.
Title
Owner
Phone
(901) 372-9133

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

5154 Stage Rd
Ste 102
Memphis, TN 38134-3118

Mailing address

5154 Stage Rd
Ste 102
Memphis, TN 38134-3118
Phone (901) 372-9133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111205000347 TN Part B Supplier - Clinic/Group Practice 7810162724 Receives reassigned benefits from 4 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

217 S Mill Ave
Dyersburg, TN 38024
Phone (901) 372-9133

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1578894887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5154 STAGE RD",
            "address_2": "STE 102",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381343118",
            "telephone_number": "901-372-9133",
            "fax_number": "901-372-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5154 STAGE RD",
            "address_2": "STE 102",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381343118",
            "telephone_number": "901-372-9133",
            "fax_number": "901-372-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS CENTER FOR WOMEN AND FAMILIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-372-9133",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "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 Jan 26, 2010; 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.