Healthcare Provider Details

I. General information

NPI: 1487747465
Provider Name (Legal Business Name): NINA K HANCOCK LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. NINA KATHERINE KIBLER

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 E UNAKA AVE
JOHNSON CITY TN
37601-4626
US

IV. Provider business mailing address

PO BOX 9054
GRAY TN
37615-9054
US

V. Phone/Fax

Practice location:
  • Phone: 423-926-0940
  • Fax: 423-926-4202
Mailing address:
  • Phone: 425-467-3600
  • Fax: 423-467-3696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMT0000000212
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: