Healthcare Provider Details

I. General information

NPI: 1447728837
Provider Name (Legal Business Name): TERRI KUBERSKI LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1078 S WATER AVE
GALLATIN TN
37066-3959
US

IV. Provider business mailing address

275 CUMBERLAND BND
NASHVILLE TN
37228-1805
US

V. Phone/Fax

Practice location:
  • Phone: 615-230-9663
  • Fax:
Mailing address:
  • Phone: 615-726-3340
  • Fax: 615-743-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4221
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: