Provider Demographics
NPI:1558021584
Name:PIECE BY PEACE THERAPEUTIC COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PIECE BY PEACE THERAPEUTIC COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LU'AUNE
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-607-7284
Mailing Address - Street 1:3672 GAILYN DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-2348
Mailing Address - Country:US
Mailing Address - Phone:901-607-7283
Mailing Address - Fax:
Practice Address - Street 1:3340 POPLAR AVE STE 205
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4680
Practice Address - Country:US
Practice Address - Phone:901-607-7284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty