Provider Demographics
NPI:1497737423
Name:CRIST, DOROTHY J (LPC LEAP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:J
Last Name:CRIST
Suffix:
Gender:F
Credentials:LPC LEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 MAYNARDVILLE PIKE
Mailing Address - Street 2:PMB #108
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-5324
Mailing Address - Country:US
Mailing Address - Phone:865-382-6049
Mailing Address - Fax:888-844-0300
Practice Address - Street 1:6923 MAYNARDVILLE PIKE
Practice Address - Street 2:PMB #108
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-5324
Practice Address - Country:US
Practice Address - Phone:865-382-6049
Practice Address - Fax:888-844-0300
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC574101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional