Provider Demographics
NPI:1538446968
Name:RAKES, KRISTI BRIM (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:BRIM
Last Name:RAKES
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 NC HIGHWAY 65
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-9609
Mailing Address - Country:US
Mailing Address - Phone:336-427-9022
Mailing Address - Fax:336-427-9030
Practice Address - Street 1:2150 NC HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-9609
Practice Address - Country:US
Practice Address - Phone:336-427-9022
Practice Address - Fax:336-427-9030
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC007259101YM0800X, 1041C0700X
VA0904009137101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health