Healthcare Provider Details

I. General information

NPI: 1346934155
Provider Name (Legal Business Name): KRISTEN MORRISON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 AIRPORT RD
ROANOKE VA
24012-1119
US

IV. Provider business mailing address

5673 AIRPORT RD
ROANOKE VA
24012-1119
US

V. Phone/Fax

Practice location:
  • Phone: 540-523-8099
  • Fax: 540-400-8808
Mailing address:
  • Phone: 540-523-8099
  • Fax: 540-400-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701012535
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: