Healthcare Provider Details

I. General information

NPI: 1245379973
Provider Name (Legal Business Name): KRISTINE LYNN NUTT LCSW, LCAS, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTINE LYNN TAMBINI LCSW, LCAS

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 ROCKINGHAM RD
ROCKINGHAM NC
28379-3615
US

IV. Provider business mailing address

814 S GROVE ST STE A
HENDERSONVILLE NC
28792-5785
US

V. Phone/Fax

Practice location:
  • Phone: 910-562-9882
  • Fax:
Mailing address:
  • Phone: 828-577-2598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number711
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004355
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: