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General NPI Number Information
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NPI Number | 1255795852
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Entity Type | Individual
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Provider Name | KRISTEN W CARDONE LPCC-S, LICDC
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Gender | Female
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Dates
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Enumeration Date | 04/09/2016
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Last Update Date | 04/14/2018
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Provider Practice Location Address
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Address Line | 6929 W 130TH ST
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130-7895
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Country | US
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Telephone | 440-887-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 685 DOGWOOD LN
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City | VERMILION
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State | OH
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Zip | 44089-2096
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Country | US
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Telephone | 614-745-5884
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.161088
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E1200691
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1200691-SUPV
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License Number State | OH
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