Provider Demographics
NPI:1245315597
Name:NESMITH, KELLIE WARD (LPC-MHSP)
Entity type:Individual
Prefix:MS
First Name:KELLIE
Middle Name:WARD
Last Name:NESMITH
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:KELLIE
Other - Middle Name:WARD
Other - Last Name:SMYTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC -MHSP
Mailing Address - Street 1:929 W 1ST NORTH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4549
Mailing Address - Country:US
Mailing Address - Phone:423-581-5342
Mailing Address - Fax:423-581-8650
Practice Address - Street 1:929 W 1ST NORTH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4549
Practice Address - Country:US
Practice Address - Phone:423-581-5342
Practice Address - Fax:423-581-8650
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011754101YP2500X
TN1822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional