Criswell, Jamie Katherine

Criswell, Jamie Katherine is an sole proprietor health care provider with primary practice located at 206 Raleigh St , Fuquay Varina NC 27526-2263. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Criswell, Jamie Katherine can be contacted via phone (919) 285-4802.

Contact Information

Primary practice address
206 Raleigh St Fuquay Varina NC 27526-2263
Phone: (919) 285-4802
Fax: (919) 882-8096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1451 North Carolina

Profile Details

NPI number 1104109123
LBN Legal business name Criswell, Jamie Katherine
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2011
Last updated Apr 14th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104109123 NPPES
North Carolina MEDICAID 6105334

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