Provider Demographics
NPI:1285443390
Name:KRIESE, ADAM (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:KRIESE
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5064 META DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5722
Mailing Address - Country:US
Mailing Address - Phone:407-446-8114
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 400
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1073
Practice Address - Country:US
Practice Address - Phone:615-567-3649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6422101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional