Provider Demographics
NPI:1982198339
Name:MARSH, KEIARA ALEXIS (LMFT)
Entity Type:Individual
Prefix:
First Name:KEIARA
Middle Name:ALEXIS
Last Name:MARSH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NEW SHACKLE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2327
Mailing Address - Country:US
Mailing Address - Phone:615-476-5733
Mailing Address - Fax:
Practice Address - Street 1:4652 INDIAN SUMMER DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-1000
Practice Address - Country:US
Practice Address - Phone:615-476-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1554106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health