Provider Demographics
NPI:1508035999
Name:CHRISTIAN FAMILY SOLUTIONS OF THE MID-SOUTH
Entity Type:Organization
Organization Name:CHRISTIAN FAMILY SOLUTIONS OF THE MID-SOUTH
Other - Org Name:MID-SOUTH COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GREENHILL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-827-3404
Mailing Address - Street 1:9160 HIGHWAY 64
Mailing Address - Street 2:SUITE 12, PMB 124
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4766
Mailing Address - Country:US
Mailing Address - Phone:901-827-3404
Mailing Address - Fax:901-827-3404
Practice Address - Street 1:311 POPLAR VIEW LANE WEST
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017
Practice Address - Country:US
Practice Address - Phone:901-827-3404
Practice Address - Fax:901-234-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000031161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty