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General NPI Number Information
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NPI Number | 1568149466
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Entity Type | Individual
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Provider Name | KRISTIN YORK LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 606 W PEACE ST
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City | RALEIGH
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State | NC
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Zip | 27605-1520
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Country | US
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Telephone | 919-602-3558
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Fax |
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Provider Business Mailing Address
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Address Line | 100 BUFFWOOD CT
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City | CARY
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State | NC
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Zip | 27518-7088
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Country | US
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Telephone | 919-602-3558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A18186
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License Number State | NC
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