Healthcare Provider Details

I. General information

NPI: 1811840135
Provider Name (Legal Business Name): KRISTAN RENEE DOOLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7570 BALES ST STE 380
LIBERTY TOWNSHIP OH
45069-7751
US

IV. Provider business mailing address

6255 ANCHOR LN
LIBERTY TOWNSHIP OH
45044-3504
US

V. Phone/Fax

Practice location:
  • Phone: 833-914-4688
  • Fax:
Mailing address:
  • Phone: 833-914-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2507730
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: