Organization Active NPI

Kristin Nakhla, Therapist, PLLC

  • Clinical Social Worker
  • Holly Springs, NC
National Provider Identifier
1760172498
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KRISTIN NAKHLA, THERAPIST, PLLC
Practice address
300 W Earp St
Holly Springs, NC 27540-8763
Phone
(919) 753-5717
NPI assigned
May 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristin Lee Nakhla, LCSWNPI 1205390994
Title
Owner, Therapist
Phone
(919) 753-5717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

300 W Earp St
Holly Springs, NC 27540-8763

Mailing address

104 Sunset Grove Dr
Holly Springs, NC 27540-6805
Phone (919) 753-5717

Other names 1

  • Be Still Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240321001616 NC Part B Supplier - Clinic/Group Practice 2769829100 Receives reassigned benefits from 2 practitioners
Practice locations: Holly Springs, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1760172498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SUNSET GROVE DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275406805",
            "telephone_number": "919-753-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W EARP ST",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408763",
            "telephone_number": "919-753-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN NAKHLA, THERAPIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "NAKHLA",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "919-753-5717",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Be Still",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.