Organization
METRO COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTIS SUMLIN JR. LCSW (OWNER)
(901) 818-5433
Entity
Organization
Contact information
Practice address
1355 LYNNFIELD RD # B, SUITE 245, MEMPHIS, TN 38119-5801
(901) 818-5433
(901) 818-5435
Mailing address
1355 LYNNFIELD RD # B, SUITE 245, MEMPHIS, TN 38119-5801
(901) 818-5433
(901) 818-5435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3697111
—
TN
01
—
4080319
BLUE CROSS OF TN
TN
Enumeration date
02/27/2008
Last updated
02/27/2008
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