Provider Demographics
NPI:1609656255
Name:HACKETT, KAYLIE (EDS, LPC-MHSP, NCC)
Entity type:Individual
Prefix:
First Name:KAYLIE
Middle Name:
Last Name:HACKETT
Suffix:
Gender:F
Credentials:EDS, LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 OLD FRANKLIN RD APT 11101
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4819
Mailing Address - Country:US
Mailing Address - Phone:615-785-7591
Mailing Address - Fax:
Practice Address - Street 1:4219 HILLSBORO PIKE STE 208
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3326
Practice Address - Country:US
Practice Address - Phone:615-200-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health