Healthcare Provider Details

I. General information

NPI: 1326244351
Provider Name (Legal Business Name): SHERRY K KRICKEL LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 DAVIDSON ST
TULLAHOMA TN
37388-3607
US

IV. Provider business mailing address

214 PARKVIEW DR
MC MINNVILLE TN
37110-2318
US

V. Phone/Fax

Practice location:
  • Phone: 888-291-4357
  • Fax:
Mailing address:
  • Phone: 931-273-3703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2450
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2405
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: