Kariss Blalock Waite, MA, LPC-MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1954 Issued in TN

Practice address

1110 Oak Cluster Dr
Suite 4
Sevierville, TN 37862-9320

Phone

(865) 774-8835

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Kariss Tenille Blalock Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1497814735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 OAK CLUSTER DR",
            "address_2": "SUITE 4",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378629320",
            "telephone_number": "865-774-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 OAK CLUSTER DR",
            "address_2": "SUITE 4",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378629320",
            "telephone_number": "865-774-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "KARISS",
        "middle_name": "BLALOCK",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "1954",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "1954",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "4653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISS",
            "last_name": "BLALOCK",
            "middle_name": "TENILLE",
            "prefix": "MISS",
            "credential": "MA,LPC-MHSP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.