Provider Demographics
NPI:1184745127
Name:QUINTERO, KAY (LPC, LSPE)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LPC, LSPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 S CONGRESS BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-2009
Mailing Address - Country:US
Mailing Address - Phone:615-597-4673
Mailing Address - Fax:615-597-4673
Practice Address - Street 1:612 S CONGRESS BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-2009
Practice Address - Country:US
Practice Address - Phone:615-597-4673
Practice Address - Fax:615-597-4673
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000703101YM0800X, 103T00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4222377OtherBLUE CROSS BLUE SHIELD
TN1274688OtherAMERIGROUP
TN26-4275807OtherTAX ID
TN5441718Medicaid
TN2500723OtherTENN CARE SELECT