Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA SHEA LCSW (PRESIDENT)
(901) 315-8625
Entity
Organization
Contact information
Practice address
4646 POPLAR AVE STE 302, MEMPHIS, TN 38117-4433
(901) 930-7397
Mailing address
4646 POPLAR AVE STE 302, MEMPHIS, TN 38117-4433
(901) 315-8625
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
06/27/2025
Last updated
04/20/2026
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