Provider Demographics
NPI:1740813633
Name:KERR, KRISTINA D (LPC-MHSP, NCC,MAC,AS)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:D
Last Name:KERR
Suffix:
Gender:F
Credentials:LPC-MHSP, NCC,MAC,AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 COLD CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-6842
Mailing Address - Country:US
Mailing Address - Phone:630-408-7548
Mailing Address - Fax:
Practice Address - Street 1:37 SANDSTONE CIR STE 92B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3168
Practice Address - Country:US
Practice Address - Phone:731-265-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN265058101YA0400X
TN2825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)