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1306737325 NPI number — ALEXIS SIERRA LYNN KELLY MS, LPC/MHSP

NPI Number: 1306737325
Health Care Provider/Practitioner: ALEXIS SIERRA LYNN KELLY MS, LPC/MHSP

Information about “1306737325” NPI (ALEXIS SIERRA LYNN KELLY MS, LPC/MHSP) exists in 1306737325 in HTML format HTML  |  1306737325 in plain Text format TXT  |  1306737325 in PDF (Portable Document Format) PDF  |  1306737325 in an XML format XML  formats.

NPI Number : 1306737325 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306737325",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KELLY",
    "FirstName": "ALEXIS",
    "MiddleName": "SIERRA LYNN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, LPC/MHSP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TERRELL",
    "OtherFirstName": "ALEXIS",
    "OtherMiddleName": "SIERRA LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "815 PECAN GARDENS CIR E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MEMPHIS",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38122-2519",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "423-534-9565",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8295 TOURNAMENT DR STE 201",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MEMPHIS",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38125-8913",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-374-5066",
    "PracticeLocationAddressFaxNumber": "719-623-0165",
    "EnumerationDate": "07/09/2025",
    "LastUpdateDate": "07/18/2025",
    "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": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "7687",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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