Camp, Charissa C

Camp, Charissa C is an sole proprietor health care provider with primary practice located at 6263 Poplar Ave Suite 932, Memphis TN 38119-4738. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Camp, Charissa C can be contacted via phone (901) 761-1511.

Contact Information

Primary practice address
6263 Poplar Ave Suite 932 Memphis TN 38119-4738
Phone: (901) 761-1511
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X P2077 Tennessee

Profile Details

NPI number 1215940515
LBN Legal business name Camp, Charissa C
Credentials PH.D., ABPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2006
Last updated Jul 23rd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215940515 NPPES
Tennessee MEDICAID 3982928
Tennessee Other 4108657

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