MEDICARE: KRISTA HUSSEY

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	12014	SC

General Provider Information

NPI Number	:	1992585822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA HUSSEY

Provider Business Mailing Address
First Line	:	77 BAHR MILL LN
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29909-7857
Country	:	US
Telephone Number	:	201-220-5774
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 CLARK SUMMIT DR STE 103
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-4200
Country	:	US
Telephone Number	:	843-473-8213
Fax Number	:	843-582-0261

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

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	04/10/2026

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Directions to “ KRISTA HUSSEY ” Practice Location

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