Healthcare Provider Details

I. General information

NPI: 1073433447
Provider Name (Legal Business Name): KILGORE'S COUNSELING SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SWEET PEA LN
HOHENWALD TN
38462-5491
US

IV. Provider business mailing address

150 SWEET PEA LN
HOHENWALD TN
38462-5491
US

V. Phone/Fax

Practice location:
  • Phone: 931-628-0219
  • Fax:
Mailing address:
  • Phone: 931-628-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER KELLY KILGORE
Title or Position: OWNER / AUTHORIZED OFFICIAL
Credential: LCSW
Phone: 931-628-0219