Desmond Marquis Lancaster, BA
Individual provider Active NPI Counselor · Henderson, TN
NPI 1972743300 · NPPES record last updated Feb 25, 2009
Key facts
- NPI
- 1972743300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 925 E Main St
Henderson, TN 38340-1709 - Phone
- (731) 989-3401
- Fax
- (731) 989-3838
- NPI assigned
- Feb 25, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Centers & Clinics of Tennessee | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
925 E Main St
Henderson, TN 38340-1709
Mailing address
925 E Main St
Henderson, TN 38340-1709
Phone (731) 989-3401
Other providers in Henderson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.