Provider Demographics
NPI:1205533007
Name:PARTRIDGE, KRISTENA TERRY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KRISTENA
Middle Name:TERRY
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LAKE BREEZE CV
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38060-3499
Mailing Address - Country:US
Mailing Address - Phone:901-590-9177
Mailing Address - Fax:
Practice Address - Street 1:6373 N QUAIL HOLLOW RD STE 202
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1405
Practice Address - Country:US
Practice Address - Phone:901-441-8322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490255451041C0700X
TN87561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical