Provider Demographics
NPI:1912582651
Name:CRAIG, KRYSELLE BAPTISTE (MA, NCC, LGPC)
Entity Type:Individual
Prefix:
First Name:KRYSELLE
Middle Name:BAPTISTE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MA, NCC, LGPC
Other - Prefix:
Other - First Name:KRYSELLE
Other - Middle Name:
Other - Last Name:BAPTISTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, NCC
Mailing Address - Street 1:1509 ELSON ST
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7018
Mailing Address - Country:US
Mailing Address - Phone:240-472-2290
Mailing Address - Fax:
Practice Address - Street 1:7225 HANOVER PKWY STE C
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2024
Practice Address - Country:US
Practice Address - Phone:240-459-3074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00891101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional