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General NPI Number Information
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NPI Number | 1043523319
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Entity Type | Individual
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Provider Name | KRISTEN FORTUNA LMHC, LPC, LPC-S
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Gender | Female
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 68 POINTE CIR STE 3102
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City | GREENVILLE
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State | SC
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Zip | 29615-6307
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Country | US
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Telephone | 864-403-0294
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Fax |
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Provider Business Mailing Address
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Address Line | 120 BRENNAN PL
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City | GREENVILLE
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State | SC
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Zip | 29609-6855
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Country | US
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Telephone | 845-341-7405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 003033
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8055
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License Number State | SC
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