West TN Neuropsychology & Mental Health Center

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

WEST TN NEUROPSYCHOLOGY & MENTAL HEALTH CENTER

Doing business as

WTN Neuropsychology Center

Practice address

382 Carriage House Dr Ste D
Jackson, TN 38305-2299

Phone

(215) 429-1730

NPI assigned

Jun 27, 2024

Last updated

Jul 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Oubah AbdallaNPI 1023852902

Title

Ceo

Phone

(215) 429-1730

Specialties & licenses 1

Addresses

Other names 1

• WTN Neuropsychology Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 1

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.

• Oubah Abdalla, PSY D

  • Psychologist
  • Jackson, TN
  • NPI 1023852902
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1851136253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 CARRIAGE HOUSE DR STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052299",
            "telephone_number": "215-429-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 CARRIAGE HOUSE DR STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052299",
            "telephone_number": "215-429-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TN NEUROPSYCHOLOGY & MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "ABDALLA",
        "authorized_official_first_name": "OUBAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-429-1730"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WTN Neuropsychology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Tennessee Rehabilitation Hospital, LLC (West Tennessee Healthcare Rehabilitation Hospital Jackson, a partnersh)
• West Tennessee Transitional Care LLC
• West Tennessee Walk in Clinic, Inc
• West TN Auto Care Inc.
• West TN Developmental Services
• West TN Pharmaceutical Care, LLC
• Mark Ellis West, PHARM.D.
• Naadia West, MD
• Adam Westmoreland, MSSW
• Stacey Whalley, MSN, FNP-BC

• Psychologist in Jackson, TN
• Providers in Jackson, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.