Healthcare Provider Details

I. General information

NPI: 1750013496
Provider Name (Legal Business Name): KRISTINE C FLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CROSS ST
AKRON OH
44311-1026
US

IV. Provider business mailing address

150 CROSS ST
AKRON OH
44311-1026
US

V. Phone/Fax

Practice location:
  • Phone: 330-996-9141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberS.2604975-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.190551
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: