Provider Demographics
NPI:1790464899
Name:KRYSA, CHRISTINE FYALKA (LCMHCS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:FYALKA
Last Name:KRYSA
Suffix:
Gender:F
Credentials:LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FALDO LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-8935
Mailing Address - Country:US
Mailing Address - Phone:252-876-6584
Mailing Address - Fax:
Practice Address - Street 1:504 POLLOCK ST
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5612
Practice Address - Country:US
Practice Address - Phone:252-876-6584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS7956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health