Provider Demographics
NPI:1992573745
Name:CRISSINGER, NIKITA KAY (MS-CMHC, LPC)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:KAY
Last Name:CRISSINGER
Suffix:
Gender:F
Credentials:MS-CMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7870 TIDEWATER DR. SUITE 206 #255
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-3713
Mailing Address - Country:US
Mailing Address - Phone:757-910-8086
Mailing Address - Fax:
Practice Address - Street 1:7870 TIDEWATER DR. SUITE 206 #255
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3713
Practice Address - Country:US
Practice Address - Phone:757-910-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health