Provider Demographics
NPI:1316004344
Name:STRONG, KRIS VARRICHIO
Entity Type:Individual
Prefix:MRS
First Name:KRIS
Middle Name:VARRICHIO
Last Name:STRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9617 WHITE CARRIAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FORSET
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-624-6845
Mailing Address - Fax:
Practice Address - Street 1:211 E. SIX FORKS RD
Practice Address - Street 2:BLDG C, SUITE 108
Practice Address - City:RALEIGH
Practice Address - State:CA
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-850-3480
Practice Address - Fax:919-899-6330
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0014851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003358Medicaid