Provider Demographics
NPI:1871227868
Name:INFINITY AND BEYOND MENTAL HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:INFINITY AND BEYOND MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-216-2049
Mailing Address - Street 1:7858 PARKMONT DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-4830
Mailing Address - Country:US
Mailing Address - Phone:901-216-2049
Mailing Address - Fax:
Practice Address - Street 1:1840 PYRAMID PL # 204
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38132-1703
Practice Address - Country:US
Practice Address - Phone:901-320-0843
Practice Address - Fax:901-284-9431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ053394Medicaid