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Individual

DR. JAMIE RAY PETTIT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ED.D LPC - MHSP

Contact information

Practice address
6401 POPLAR AVE STE 500, MEMPHIS, TN 38119-4808
(901) 746-9438
(901) 410-4536
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-2534

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2300
TN
101YP2500X
Professional Counselor
Primary
2300
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00002300
LPC NUMBER
TN
05
Q051103
TN
Enumeration date
02/07/2019
Last updated
02/12/2026
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