Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Krystin Jherel Fullwood

Individual provider Behavior Technician · NPI 1629505599

Krystin Jherel Fullwood is a Behavior Technician in Summerfield, North Carolina. Licensed in North Carolina. Registered with an NPI since 2017.

Licensed in
NC
In the registry since
2017
Specialties on file
2

Practice location Address checks out

6633 Alley Rd
Summerfield, NC 27358-9203
Phone: (336) 280-9976
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence A19108 (NC)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1629505599
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 22, 2017
Last updated in NPPESSeptember 20, 2023
Certification dateSeptember 20, 2023