Provider Demographics
NPI:1720677099
Name:INCH, KALISTA MORGAN
Entity type:Individual
Prefix:
First Name:KALISTA
Middle Name:MORGAN
Last Name:INCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 WAKE FOREST RD STE 349
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-0010
Mailing Address - Country:US
Mailing Address - Phone:570-850-0042
Mailing Address - Fax:
Practice Address - Street 1:4030 WAKE FOREST RD STE 349
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-0010
Practice Address - Country:US
Practice Address - Phone:252-371-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21286101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health