Healthcare Provider Details

I. General information

NPI: 1003731357
Provider Name (Legal Business Name): KRISTINA CAPPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 READING RD STE A
MASON OH
45040-2654
US

IV. Provider business mailing address

969 READING RD STE A
MASON OH
45040-2654
US

V. Phone/Fax

Practice location:
  • Phone: 513-445-9688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2608063-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: