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General NPI Number Information
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NPI Number | 1588275945
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Entity Type | Individual
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Provider Name | KRISTEN ANNE CARLOSH LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 1642 HILLWOOD DR APT G1
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City | KNOXVILLE
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State | TN
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Zip | 37920-2658
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Country | US
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Telephone | 423-915-9532
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Fax |
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Provider Business Mailing Address
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Address Line | 1642 HILLWOOD DR APT G1
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City | KNOXVILLE
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State | TN
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Zip | 37920-2658
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Country | US
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Telephone | 423-915-9532
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 000624735
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4531
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License Number State | TN
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