Individual
CRYSTAL KITTRELL-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LPC
Contact information
Practice address
3575 BRIDGE RD STE 8, # 201, SUFFOLK, VA 23435
(757) 632-7107
Mailing address
3575 BRIDGE RD STE 8, #201, SUFFOLK, VA 23435
(757) 632-7107
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701004619
VA
101YP2500X
Professional Counselor
0701004619
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701004619
LICENSED PROFESSIONAL COUNSELOR
VA
Enumeration date
09/18/2013
Last updated
07/05/2023
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