Provider Demographics
NPI:1023156346
Name:WESTERMAN, MANDY RENE' SCOTT (LMSW)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:RENE' SCOTT
Last Name:WESTERMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:RENE'
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW
Mailing Address - Street 1:2231 WELLSPRING LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0927
Mailing Address - Country:US
Mailing Address - Phone:731-414-8401
Mailing Address - Fax:
Practice Address - Street 1:2714 UNION AVENUE EXT STE 400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-4436
Practice Address - Country:US
Practice Address - Phone:901-320-6112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health