Provider Demographics
NPI:1578717393
Name:KEMP, CHRISTA MOORE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:MOORE
Last Name:KEMP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4017 GUILFORD CT NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-4503
Mailing Address - Country:US
Mailing Address - Phone:704-795-3703
Mailing Address - Fax:
Practice Address - Street 1:4017 GUILFORD CT NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-4503
Practice Address - Country:US
Practice Address - Phone:704-795-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional