Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Headshop

Organization Professional Counselor · NPI 1508643818

The Headshop is a Professional Counselor in Memphis, Tennessee. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

5104 Stage Rd
Memphis, TN 38134-3164
Phone: (901) 870-8682
Fax: (901) 424-9078
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X

Record details

NPI number1508643818
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationThe Headshop
Authorized official Mardrey Wade Kiles — Owner, Clinical Director, Therapist · (901) 870-8682
Other names Mardrey Wade Kiles; The Headshop
NPI enumeratedSeptember 11, 2023
Last updated in NPPESOctober 27, 2025
Certification dateOctober 27, 2025
Mailing address1788 Cheshunt Ln, Cordova, TN 38016-3507

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