Healthcare Provider Details

I. General information

NPI: 1306387618
Provider Name (Legal Business Name): MRS. KRISTA CHICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 CREEKSIDE CT
HELENA AL
35080-3286
US

IV. Provider business mailing address

511 CREEKSIDE CT
HELENA AL
35080-3286
US

V. Phone/Fax

Practice location:
  • Phone: 205-202-9685
  • Fax:
Mailing address:
  • Phone: 205-202-9685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3596
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: