Provider Demographics
NPI:1952663007
Name:BYERS, KRISTIN LORENE (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LORENE
Last Name:BYERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 N MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2516
Mailing Address - Country:US
Mailing Address - Phone:919-496-7781
Mailing Address - Fax:919-496-1477
Practice Address - Street 1:104 N MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2516
Practice Address - Country:US
Practice Address - Phone:919-496-7781
Practice Address - Fax:919-496-1477
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0106201041C0700X
NCP009285104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical