Betty Duke Shadish | Memphis, TN • PECOS Search

Betty Duke Shadish

Social Worker

Behavioral Health & Social Service Providers

1030 Jefferson Ave, Memphis, TN 38104-2127

PECOS Enrollment

Based on the most recent information from CMS, provider Betty Duke Shadish does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1467562751
Provider Type
Individual
Full Name
Shadish, Betty Duke
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/30/2006
Last Updated
7/8/2007

Contact Information

Practice Location

1030 Jefferson Ave, Memphis, TN 38104-2127

Unlisted Fax

Mailing Location

1309 E Crestwood Dr, Memphis, TN 38119-5000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License TN89 Tennessee