Provider Demographics
NPI:1366556177
Name:KERNES, TERRY WAYNE (LPC)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:WAYNE
Last Name:KERNES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2105 SW SMITH ST
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3505
Mailing Address - Country:US
Mailing Address - Phone:816-229-3009
Mailing Address - Fax:816-229-3009
Practice Address - Street 1:520 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64124-1514
Practice Address - Country:US
Practice Address - Phone:816-404-6352
Practice Address - Fax:816-404-6347
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS119101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO001027OtherLICENSE NUMBER