Kelly Woodburn, LPC-MHSP (T)

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6390 Issued in TN

Practice address

10261 Kingston Pike
Knoxville, TN 37922-3276

Phone

(865) 283-1777

NPI assigned

Mar 28, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1386495372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10261 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223276",
            "telephone_number": "865-283-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10261 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223276",
            "telephone_number": "865-283-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURN",
        "first_name": "KELLY",
        "credential": "LPC-MHSP (T)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "6390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Lawrence Wood, FNP-BC
• Gary R. Woodall, D.D.S.
• Carla B Woodard, NP
• Madison Kate Woodard, PA-C
• Sherrod Woodard, PTA
• Carrie Beth Woodby, FNP
• Lillian Hope Woodby
• Doris Moral Woodhull
• Woodrow W Gwinn Jr
• Woodrow W. Gwinn, Jr.

• Mental Health Counselor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.