Provider Demographics
NPI:1689303406
Name:HELFRICK, KRISTIN M (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:HELFRICK
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 MIDDLETON ST # B
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5358
Mailing Address - Country:US
Mailing Address - Phone:954-383-3012
Mailing Address - Fax:
Practice Address - Street 1:1105 MIDDLETON ST # B
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5358
Practice Address - Country:US
Practice Address - Phone:954-383-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-23-68606103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst