MEDICARE: KRISTINA MARIE BARRY LPC, LPCS-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6336	SC

General Provider Information

NPI Number	:	1114553377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA MARIE BARRY LPC, LPCS-C

Provider Business Mailing Address
First Line	:	2154 NOISETTE BLVD UNIT 226
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-2059
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2154 NOISETTE BLVD UNIT 226
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-2059
Country	:	US
Telephone Number	:	843-670-3093
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2020
Last Update Date	:	12/10/2025

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