MEDICARE: MS. KRISTIN MASTER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701004408	VA

General Provider Information

NPI Number	:	1336305572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTIN MASTER LPC

Provider Business Mailing Address
First Line	:	2252 SANDALWOOD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1322
Country	:	US
Telephone Number	:	703-407-1980
Fax Number	:

Provider Business Practice Location Address
First Line	:	2252 SANDALWOOD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1322
Country	:	US
Telephone Number	:	703-407-1980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	08/26/2025

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