The Headshop
NPI 1508643818ActiveOrganization· Counselor, Professional· Memphis, TN
Counselor, Professional in Memphis, Tennessee, registered in NPPES in September 2023, part of The Headshop. The authorized official on file is Mardrey Alicia Wade Kiles, LPC- MHSP, Owner, Clinical Director, Therapist.
Overview
| NPI | 1508643818 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | The Headshop |
| NPI issued | Sep 11, 2023 |
| Last updated in NPPES | Oct 27, 2025 |
| Certified by provider | Oct 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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