Healthcare Provider Details

I. General information

NPI: 1811249832
Provider Name (Legal Business Name): KRISTIN N FIELDS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN N IGNATIOUS LPCC

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13201 GRANGER RD STE 8
GARFIELD HEIGHTS OH
44125-1979
US

IV. Provider business mailing address

13201 GRANGER RD STE 8
GARFIELD HEIGHTS OH
44125-1979
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-2255
  • Fax: 216-378-3906
Mailing address:
  • Phone: 216-831-2255
  • Fax: 216-378-3906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.0900178
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0900178
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: