Healthcare Provider Details

I. General information

NPI: 1629529425
Provider Name (Legal Business Name): ALEXIS RHAMES KEITH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 MARTIN LUTHER KING JR AVE STE V701
KNOXVILLE TN
37915-1621
US

IV. Provider business mailing address

2425 MARTIN LUTHER KING JR AVE STE V701
KNOXVILLE TN
37915-1621
US

V. Phone/Fax

Practice location:
  • Phone: 865-224-6021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number4186
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP7238
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number6675
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: