Provider Demographics
NPI:1891848164
Name:MASSEY, LASHAUNDA POINDEXTER (PHD)
Entity Type:Individual
Prefix:DR
First Name:LASHAUNDA
Middle Name:POINDEXTER
Last Name:MASSEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 COTSWOLD LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-4543
Mailing Address - Country:US
Mailing Address - Phone:901-452-6424
Mailing Address - Fax:901-452-6425
Practice Address - Street 1:2693 UNION AVENUE EXT
Practice Address - Street 2:STE #200
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-4403
Practice Address - Country:US
Practice Address - Phone:901-452-6424
Practice Address - Fax:901-452-6425
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2377103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3680040Medicare PIN