Provider Demographics
NPI:1043352479
Name:TOWNSEL, AUDREY LINDALE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:LINDALE
Last Name:TOWNSEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4071
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-4071
Mailing Address - Country:US
Mailing Address - Phone:901-413-8663
Mailing Address - Fax:
Practice Address - Street 1:4646 POPLAR AVE STE 412
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117
Practice Address - Country:US
Practice Address - Phone:901-413-8663
Practice Address - Fax:901-618-2325
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN3010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health