Provider Demographics
NPI:1144609058
Name:VISION BEHAVIORAL HEALTH COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:VISION BEHAVIORAL HEALTH COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:COUNSELOR
Authorized Official - Phone:901-249-7970
Mailing Address - Street 1:2400 POPLAR AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3252
Mailing Address - Country:US
Mailing Address - Phone:901-249-7970
Mailing Address - Fax:901-791-4390
Practice Address - Street 1:2400 POPLAR AVE STE 410
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3252
Practice Address - Country:US
Practice Address - Phone:901-272-2622
Practice Address - Fax:901-272-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000014840101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty