Provider Demographics
NPI:1457861338
Name:MCGLOTHIN, KELSIE BOWMAN (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KELSIE
Middle Name:BOWMAN
Last Name:MCGLOTHIN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MS
Other - First Name:KELSIE
Other - Middle Name:LEIGH
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:305 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4824
Mailing Address - Country:US
Mailing Address - Phone:615-517-1362
Mailing Address - Fax:
Practice Address - Street 1:305 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4824
Practice Address - Country:US
Practice Address - Phone:865-588-1718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN1670106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health