Provider Demographics
NPI:1689138687
Name:CRYMES, KRISTIN (BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:CRYMES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:202 MCSWAIN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-1848
Mailing Address - Country:US
Mailing Address - Phone:864-509-5338
Mailing Address - Fax:
Practice Address - Street 1:440 ROPER MOUNTAIN RD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4235
Practice Address - Country:US
Practice Address - Phone:864-248-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
RBT-16-18653106S00000X
SC1-19-40352103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician