Jacquelyn Eliza Kiernan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4125 Issued in TN

Practice address

214 E Mountcastle Dr Ste 1
Johnson City, TN 37601-2509

Phone

(423) 283-4958

Fax

(423) 283-7135

NPI assigned

Aug 11, 2015

Last updated

Jan 10, 2019By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1760868970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E MOUNTCASTLE DR STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012509",
            "telephone_number": "423-283-4958",
            "fax_number": "423-283-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E MOUNTCASTLE DR STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012509",
            "telephone_number": "423-283-4958",
            "fax_number": "423-283-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "JACQUELYN",
        "middle_name": "ELIZA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imran Khan, MD
• Shweta Kharalkar, MD
• Azadeh S Khezri, MD
• James Kidd, PT
• Kids First Children's Urgent Care
• Angel Kilgore
• Rachael Kilgore
• Cecelia Kim
• Barbara O Kimbrough, MD
• Stephen Michael Kimbrough, MD

• Professional Counselor in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.