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Organization

CREEKSIDE CENTER FOR DEPRESSION AND TMS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PEPPER B PRATT PH.D., LPC, MHSP (PARTNER)
(731) 660-0199
Entity
Organization

Contact information

Practice address
174 MURRAY GUARD DR, SUITE B, JACKSON, TN 38305-3742
(731) 660-0199
(731) 660-3650
Mailing address
174 MURRAY GUARD DR, SUITE B, JACKSON, TN 38305-3742
(731) 660-0199
(731) 660-3650

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
2084P0800X
Psychiatry Physician
Primary
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist

Other

Enumeration date
03/22/2012
Last updated
03/22/2012
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