Organization
THE WELLNESS SPACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTE SMITH-FASON DNP, FNP/PMHNP-BC (CEO)
(901) 450-3995
Entity
Organization
Contact information
Practice address
1331 UNION AVE STE 1152, MEMPHIS, TN 38104-7509
(901) 450-3995
(901) 450-3995
Mailing address
5821 PARK AVE # 171432, MEMPHIS, TN 38119-5134
(901) 450-3995
(901) 450-3995
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/15/2025
Last updated
11/14/2025
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