Provider Demographics
NPI:1679548184
Name:HARRELL, JERILANE LOVETT (LPCC)
Entity Type:Individual
Prefix:MS
First Name:JERILANE
Middle Name:LOVETT
Last Name:HARRELL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 HICKORY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-5499
Mailing Address - Country:US
Mailing Address - Phone:270-703-7170
Mailing Address - Fax:
Practice Address - Street 1:195 HICKORY CREEK LN
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-5499
Practice Address - Country:US
Practice Address - Phone:270-703-7170
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0498101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor