Organization
CREEKSIDE CENTER FOR DEPRESSION AND TMS
Active
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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