Krystal Dominique Fortney, LPC-MHSP
Individual provider Active NPI Professional Counselor · Nashville, TN
NPI 1639623523 · NPPES record last updated Feb 11, 2020
Key facts
- NPI
- 1639623523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC0000003700 (TN)
- Practice address
- 4235 Hillsboro Pike
Nashville, TN 37215-3344 - Phone
- (901) 827-7956
- NPI assigned
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC0000003700 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eden Eman Counseling & Consulting, LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC0000003700 | TN | Yes |
Addresses
Primary practice location
4235 Hillsboro Pike
Nashville, TN 37215-3344
Mailing address
7600 Cabot Dr Apt 115
Nashville, TN 37209-4381
Phone (901) 827-7956
Other providers in Nashville, TN
- Robert L Forti
- Fortier Substance Abuse Testing, Inc.
- Shelby Lynne Fortin
- Amy Helms Fortner
- Kimberly B Fortner
- Michelle Renee Fortney
- Stephanie Dawn Fortney
- Kristy Noel Fortune
- Sophia Ann Forystek
- Nichole Fosdick
All providers in Nashville, TN · Professional Counselor in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.