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1215627633 NPI number — KRISTINA EMANUEL DOVRE MS, NCC, LCPC

NPI Number: 1215627633
Health Care Provider/Practitioner: KRISTINA EMANUEL DOVRE MS, NCC, LCPC

Information about “1215627633” NPI (KRISTINA EMANUEL DOVRE MS, NCC, LCPC) exists in 1215627633 in HTML format HTML  |  1215627633 in plain Text format TXT  |  1215627633 in PDF (Portable Document Format) PDF  |  1215627633 in an XML format XML  formats.

NPI Number : 1215627633 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215627633",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DOVRE",
    "FirstName": "KRISTINA",
    "MiddleName": "EMANUEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, NCC, LCPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BRAKEBUSH",
    "OtherFirstName": "KRISTINA",
    "OtherMiddleName": "EMANUEL",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS, NCC, LCPC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 187",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LIBERTY LAKE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "99019-0187",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "406-671-4295",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1939 BEVERLY HILL BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BILLINGS",
    "PracticeLocationAddressStateName": "MT",
    "PracticeLocationAddressPostalCode": "59102-2311",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "406-671-4295",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/09/2023",
    "LastUpdateDate": "01/21/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "MHC.LH.61612267",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "60135",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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