Healthcare Provider Details

I. General information

NPI: 1184542797
Provider Name (Legal Business Name): KRISTA NORDGREN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 MARTIN LUTHER KING PKWY STE 205
DURHAM NC
27707-3586
US

IV. Provider business mailing address

3830 ZENITH PL
DURHAM NC
27705-2118
US

V. Phone/Fax

Practice location:
  • Phone: 919-423-0404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRISTA ANNE NORDGREN
Title or Position: OWNER, COUNSELOR
Credential: LCMHC
Phone: 919-423-0404