Provider Demographics
NPI:1306814967
Name:SMALL, DON KRIS (LMHC)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:KRIS
Last Name:SMALL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 W MCCLAIN AVE STE B
Mailing Address - Street 2:P.O. BOX 462
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-1129
Mailing Address - Country:US
Mailing Address - Phone:812-754-1660
Mailing Address - Fax:812-754-1664
Practice Address - Street 1:969 W MCCLAIN AVE STE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1129
Practice Address - Country:US
Practice Address - Phone:812-754-1660
Practice Address - Fax:812-754-1664
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000208A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health