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1164242566 NPI number — BRENDA ANN KELLER LPC

NPI Number: 1164242566
Health Care Provider/Practitioner: BRENDA ANN KELLER LPC

Information about “1164242566” NPI (BRENDA ANN KELLER LPC) exists in 1164242566 in HTML format HTML  |  1164242566 in plain Text format TXT  |  1164242566 in PDF (Portable Document Format) PDF  |  1164242566 in an XML format XML  formats.

NPI Number : 1164242566 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164242566",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KELLER",
    "FirstName": "BRENDA",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6107 MANCHESTER RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KNOXVILLE",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37920-6453",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "229-834-8087",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "KNOXVILLE COUNSELING SERVICES 10414 JACKSON OAKS WAY",
    "SecondLinePracticeLocationAddress": "SUITE 103",
    "PracticeLocationAddressCityName": "KNOXVILLE",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37922",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "865-621-4044",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/11/2024",
    "LastUpdateDate": "10/11/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "LPC011730",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "6904",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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