Healthcare Provider Details

I. General information

NPI: 1093126864
Provider Name (Legal Business Name): KRISTEN WEEKES MS, BSL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN RESSLER

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 VARTAN WAY STE 204
HARRISBURG PA
17110-9763
US

IV. Provider business mailing address

61 STRATFORD VLG
LANCASTER PA
17602-1165
US

V. Phone/Fax

Practice location:
  • Phone: 717-920-9434
  • Fax: 717-920-9197
Mailing address:
  • Phone: 177-669-8166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBH001185
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH001185
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: