Provider Demographics
NPI:1265692933
Name:SEXTON, SHELLY K (LPC)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:K
Last Name:SEXTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6628 CENTRAL AVENUE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-1400
Mailing Address - Country:US
Mailing Address - Phone:865-219-9444
Mailing Address - Fax:865-219-9555
Practice Address - Street 1:6628 CENTRAL AVENUE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1400
Practice Address - Country:US
Practice Address - Phone:865-219-9444
Practice Address - Fax:865-219-9555
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional