Kerry Alice Chrysalis Bursley, LPC
Counselor, Professional in Raymore, MO. Individual provider (NPI-1).
NPI number1780192856
StatusActive
Last updated in NPPESNov 21, 2023
Details
- NPI
- 1780192856
- Entity type
- Individual (NPI-1)
- Name
- Kerry Alice Chrysalis Bursley
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 11, 2018
- Certification date
- Nov 21, 2023
- Last updated
- Nov 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2017042943 | MO | Yes |
Other names
- Kerry Alice Earthsoul (Former Name)
Practice location
501 N Sunset LnRaymore, MO 64083-9402
Phone 844-853-8937
Mailing address
1800 CommunityClinton, MO 64735-8804
Phone 660-885-8131
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