Healthcare Provider Details

I. General information

NPI: 1760172498
Provider Name (Legal Business Name): KRISTIN NAKHLA, THERAPIST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W EARP ST
HOLLY SPRINGS NC
27540-8763
US

IV. Provider business mailing address

104 SUNSET GROVE DR
HOLLY SPRINGS NC
27540-6805
US

V. Phone/Fax

Practice location:
  • Phone: 919-753-5717
  • Fax:
Mailing address:
  • Phone: 919-753-5717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN LEE NAKHLA
Title or Position: OWNER, THERAPIST
Credential: LCSW
Phone: 919-753-5717