Healthcare Provider Details

I. General information

NPI: 1992636484
Provider Name (Legal Business Name): KIRSTEN DANTIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8241 SUMMA AVE STE A
BATON ROUGE LA
70809-3735
US

IV. Provider business mailing address

8241 SUMMA AVE STE A
BATON ROUGE LA
70809-3735
US

V. Phone/Fax

Practice location:
  • Phone: 225-800-2041
  • Fax:
Mailing address:
  • Phone: 225-800-2041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIRSTEN DANTIN LYONS
Title or Position: OWNER
Credential: M.S., LPC-A, NCC
Phone: 225-800-2041