Provider Demographics
NPI:1114040847
Name:SUDIE S CUSHMAN
Entity Type:Organization
Organization Name:SUDIE S CUSHMAN
Other - Org Name:MIDTOWN MENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESCREENER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUDIE
Authorized Official - Middle Name:STOWERS
Authorized Official - Last Name:CUSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:M'ED
Authorized Official - Phone:901-577-9400
Mailing Address - Street 1:427 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38126-2023
Mailing Address - Country:US
Mailing Address - Phone:901-577-9400
Mailing Address - Fax:901-577-0207
Practice Address - Street 1:427 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38126-2023
Practice Address - Country:US
Practice Address - Phone:901-577-9400
Practice Address - Fax:901-577-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health