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CREEKSIDE CENTER FOR DEPRESSION AND TMS NPI 1356617401


NPI Information

NPI: 1356617401
Provider Name: CREEKSIDE CENTER FOR DEPRESSION AND TMS
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
174 MURRAY GUARD DR
SUITE B
JACKSON, TN
ZIP 38305
Phone: (731) 660-0199
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CREEKSIDE CENTER FOR DEPRESSION AND TMS is a psychiatry psychiatry neurology in Jackson, TN. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. CREEKSIDE CENTER FOR DEPRESSION AND TMS NPI is 1356617401. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

174 MURRAY GUARD DR
SUITE B
JACKSON, TN
ZIP 38305-742
Phone: (731) 660-0199
Fax: (731) 660-3650

The provider's authorized official is Pepper B Pratt .
The authorized official title is Partner and has the following contact phone number (731) 660-0199.

The enumeration date for this NPI number is 3/22/2012 and was last updated on 3/22/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessionalNo
2103T00000XPsychologistNo
3103TC0700XPsychologistClinicalNo
4364SP0808XClinical Nurse SpecialistPsychiatric/Mental HealthNo
52084P0800XPsychiatry & NeurologyPsychiatryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13683445MEDICARE PINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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