Provider Demographics
NPI:1992860241
Name:KERSTETTER, WILLIAM CARL (LPC/MHSP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CARL
Last Name:KERSTETTER
Suffix:
Gender:M
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 1:218 EAST MAIN STREET
Mailing Address - Street 2:PO BOX 572
Mailing Address - City:MONTEAGLE
Mailing Address - State:TN
Mailing Address - Zip Code:37356-7015
Mailing Address - Country:US
Mailing Address - Phone:931-924-0042
Mailing Address - Fax:
Practice Address - Street 1:218 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MONTEAGLE
Practice Address - State:TN
Practice Address - Zip Code:37356
Practice Address - Country:US
Practice Address - Phone:931-924-0042
Practice Address - Fax:931-924-0043
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional