Proffitt, James Lewis

Proffitt, James Lewis is an individual health care provider with primary practice located at 2823 Airways Blvd , Jackson TN 38301-5611. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Proffitt, James Lewis can be contacted via phone (731) 293-9946.

Contact Information

Primary practice address
2823 Airways Blvd Jackson TN 38301-5611
Phone: (731) 293-9946
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1618 Tennessee
Behavioral Health & Social Service Providers / Counselor 101Y00000X PE1618 Tennessee

Profile Details

NPI number 1356442636
LBN Legal business name Proffitt, James Lewis
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 21st, 2022 - about 2 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 1356442636 NPPES
Tennessee MEDICAID 5441164

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