Provider Demographics
NPI:1639764665
Name:FRIERSON, KATELYND (LADAC II)
Entity Type:Individual
Prefix:
First Name:KATELYND
Middle Name:
Last Name:FRIERSON
Suffix:
Gender:F
Credentials:LADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 MATTHEWS AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2118
Mailing Address - Country:US
Mailing Address - Phone:423-505-8895
Mailing Address - Fax:
Practice Address - Street 1:186 N 1ST ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37213-1102
Practice Address - Country:US
Practice Address - Phone:615-242-3576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDC0000001372101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)