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General NPI Number Information
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NPI Number | 1043926074
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Entity Type | Individual
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Provider Name | KRISTEN NICHOLE PRIBANICH LPC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 2848 LOCKWOOD CIR
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City | STOW
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State | OH
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Zip | 44224-5135
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Country | US
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Telephone | 585-507-1728
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Fax |
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Provider Business Mailing Address
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Address Line | 2722 ERIE AVE SUITE 219 PMB122347
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City | CINCINNATI
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State | OH
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Zip | 45208
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Country | US
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Telephone | 216-677-5431
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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 | C.2204767
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License Number State | OH
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