Provider Demographics
NPI:1467910794
Name:POINDEXTER, KRISTI MYLES (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:MYLES
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 LEGACY LAKE CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-8758
Mailing Address - Country:US
Mailing Address - Phone:901-830-9474
Mailing Address - Fax:
Practice Address - Street 1:109 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3018
Practice Address - Country:US
Practice Address - Phone:901-830-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004307101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional