Provider Demographics
NPI:1609201391
Name:MYRICKS, KRISTI WILSON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:WILSON
Last Name:MYRICKS
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 1:1733 BROOKFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35214-4837
Mailing Address - Country:US
Mailing Address - Phone:205-960-3303
Mailing Address - Fax:205-326-8606
Practice Address - Street 1:1733 BROOKFIELD LN
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35214-4837
Practice Address - Country:US
Practice Address - Phone:205-960-3303
Practice Address - Fax:205-326-8606
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional