Provider Demographics
NPI:1609174697
Name:CRUMP, KRISTY A (LCPC, NCC)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:A
Last Name:CRUMP
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 S MAIN ST STE 1D
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3978
Mailing Address - Country:US
Mailing Address - Phone:443-502-0714
Mailing Address - Fax:
Practice Address - Street 1:336 S MAIN ST STE 1D
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3978
Practice Address - Country:US
Practice Address - Phone:443-502-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00396600101YP2500X
MDLC3795101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional