Provider Demographics
NPI:1235482753
Name:MEYRICK, KRISTINA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:MEYRICK
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 YORK RD STE D4
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1031
Mailing Address - Country:US
Mailing Address - Phone:215-491-9900
Mailing Address - Fax:215-491-9902
Practice Address - Street 1:2370 YORK RD STE D4
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929
Practice Address - Country:US
Practice Address - Phone:215-491-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007294101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional