Provider Demographics
NPI:1336669555
Name:BROWN, KRYSTAL C (LPCC)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KRYSTAL
Other - Middle Name:
Other - Last Name:GREENAWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:PO BOX 614
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-0614
Mailing Address - Country:US
Mailing Address - Phone:270-886-2205
Mailing Address - Fax:270-886-0392
Practice Address - Street 1:735 NORTH DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2620
Practice Address - Country:US
Practice Address - Phone:270-886-5163
Practice Address - Fax:270-886-5178
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
KY269399101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)