Individual
KELSEY CRIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA, CCS, LCAS
Contact information
Practice address
120 COASTAL HORIZONS DR, SHALLOTTE, NC 28470-6094
(910) 758-4451
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
24385
NC
101YM0800X
Mental Health Counselor
A14201
NC
101YP2500X
Professional Counselor
Primary
A14201
NC
Other
Enumeration date
05/15/2023
Last updated
05/23/2023
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