Individual provider Active NPI

Krystle Marie Herrera, LCSW

  • Clinical Social Worker
  • Clarksville, TN
National Provider Identifier
1972173375
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9121 Issued in TN
Practice address
2953 McManus Cir
Clarksville, TN 37042-1464
Phone
(760) 449-6816
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 00001089 KY
Clinical Social Worker 1041C0700X 0904019009 VA
Clinical Social Worker 1041C0700X 9121 TN Primary
Clinical Social Worker 1041C0700X 135760 CA

Addresses

Primary practice location

2953 McManus Cir
Clarksville, TN 37042-1464

Mailing address

2953 McManus Cir
Clarksville, TN 37042-1464
Phone (760) 449-6816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
135760CAMDClinical Social Worker
00001089KYMDClinical Social Worker
0904019009VAMDClinical Social Worker
9121TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1972173375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2953 MCMANUS CIR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370421464",
            "telephone_number": "760-449-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2953 MCMANUS CIR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370421464",
            "telephone_number": "760-449-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "KRYSTLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "00001089",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904019009",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "9121",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "135760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.