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General NPI Number Information
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NPI Number | 1548699689
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Entity Type | Organization
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Legal Business Name | MARILYN M KERR, LPC, LLC
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 230 GOODMAN RD E STE 3-204
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City | SOUTHAVEN
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State | MS
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Zip | 38671-5152
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Country | US
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Telephone | 901-870-6844
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Fax | 662-349-8772
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Provider Business Mailing Address
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Address Line | 230 GOODMAN RD E STE 3-204
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City | SOUTHAVEN
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State | MS
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Zip | 38671-5152
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Country | US
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Telephone | 901-870-6844
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Fax | 662-349-8772
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MARILYN M KERR
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Credential | L.P.C.
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Telephone | 901-870-6844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0917
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0917
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License Number State | MS
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