Individual
KRYSTLE M WORKING DRURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4466 STATE ROUTE 261 STE 1, NEWBURGH, IN 47630-2832
(812) 490-2100
Mailing address
4466 STATE ROUTE 261 STE 1, NEWBURGH, IN 47630-2832
(812) 490-2100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6211
KY
1041C0700X
Clinical Social Worker
33006405A
IN
1041C0700X
Clinical Social Worker
Primary
34006969A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
254098
LCSW
KY
01
—
34006969A
LCSW
IN
05
—
7100514370
—
KY
Enumeration date
10/26/2011
Last updated
06/07/2020
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