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General NPI Number Information
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NPI Number | 1316248776
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Entity Type | Individual
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Provider Name | KRISTEN MACHADO MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 2863 N HIGHWAY 17
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City | MT PLEASANT
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State | SC
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Zip | 29466-8962
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Country | US
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Telephone | 843-469-6803
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 652
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City | ISLE OF PALMS
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State | SC
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Zip | 29451-0652
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Country | US
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Telephone | 843-469-6803
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5242
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License Number State | SC
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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 | 5464
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License Number State | SC
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