Individual
MR. ALLEN KERRIE GHOLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
9035 E SANDIDGE RD STE 201, OLIVE BRANCH, MS 38654-3563
(662) 234-7601
Mailing address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0000005776
TN
1041C0700X
Clinical Social Worker
Primary
C-10110
MS
Other
Enumeration date
03/30/2007
Last updated
04/13/2026
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