Provider Demographics
| NPI: | 1487126272 |
|---|---|
| Name: | IAC ASSOCIATES PLLC |
| Entity type: | Organization |
| Organization Name: | IAC ASSOCIATES PLLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VP, RCM AND PAYOR RELATIONS |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MELISSA |
| Authorized Official - Middle Name: | A |
| Authorized Official - Last Name: | BAILEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 972-935-1409 |
| Mailing Address - Street 1: | 6101 W PLANO PKWY STE 230 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PLANO |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75093-8373 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 940-360-4245 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 6401 POPLAR AVE STE 500 |
| Practice Address - Street 2: | |
| Practice Address - City: | MEMPHIS |
| Practice Address - State: | TN |
| Practice Address - Zip Code: | 38119-4808 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 901-746-9438 |
| Practice Address - Fax: | 941-746-9331 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-12-18 |
| Last Update Date: | 2025-04-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 207QA0401X | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | Group - Multi-Specialty |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Multi-Specialty |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MS | 03401509 | Medicaid | |
| TN | Q048108 | Medicaid |