KRYSTLE KRYSTALIA KOUGIAS LAC
NPI 1003486465
Counselor - Mental Health in Oaklyn, NJ
Active since June 29, 2021
About Krystle Krystalia Kougias Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRYSTLE KRYSTALIA KOUGIAS LAC (NPI 1003486465) is an individual mental health provider in Oaklyn, New Jersey and active in the NPI registry since June 2021.
NPPES Registry Identity
NPI1003486465
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKRYSTLE KRYSTALIA KOUGIASCredential: LAC
Location Address304 NEWTON AVEOaklyn, NJ 08107-1446
Mailing Address304 Newton AveOaklyn, NJ 08107-1446 · (609) 543-9752
Phone(609) 543-9752
Sole ProprietorNo
Enumeration DateJune 29, 2021
Last NPPES UpdateAugust 2, 20212 updates tracked since enumeration
NPPES CertifiedAugust 2, 2021
✔ NPI 1003486465 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
304 NEWTON AVE, Oaklyn, NJ 08107
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Professional)
304 NEWTON AVE, SUITE 100
OAKLYN, NJ 08107
OAKLYN, NJ 08107
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003486465, enumerated as an "individual" on June 29, 2021.
The provider is located at 304 NEWTON AVE OAKLYN, NJ 08107 and the phone number is (609) 543-9752.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
