Provider Demographics
NPI:1912054016
Name:FURRH, SANDY (LCSW)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:FURRH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S COOPER ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5611
Mailing Address - Country:US
Mailing Address - Phone:901-844-4356
Mailing Address - Fax:901-844-4356
Practice Address - Street 1:1000 S COOPER ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-5611
Practice Address - Country:US
Practice Address - Phone:901-844-4356
Practice Address - Fax:901-844-4356
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN001163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3695836Medicaid
TN3695836Medicare ID - Type Unspecified