Provider Demographics
NPI:1073374559
Name:BEARDEN, KRISTIN NOEL TOWNSEND (LCMHC, NCC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NOEL TOWNSEND
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MAGNOLIA RD
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-9768
Mailing Address - Country:US
Mailing Address - Phone:302-540-1437
Mailing Address - Fax:
Practice Address - Street 1:105 MAGNOLIA RD
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-9768
Practice Address - Country:US
Practice Address - Phone:302-540-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14849101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor