MEDICARE: KRISTEN NOEL DUA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2018028295	MO
2	101YP2500X	Professional Counselor	180.007071	IL

General Provider Information

NPI Number	:	1376776575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN NOEL DUA LPC

Provider Business Mailing Address
First Line	:	7505 NW TIFFANY SPRINGS PKWY STE 510
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64153-1389
Country	:	US
Telephone Number	:	605-660-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 NW TIFFANY SPRINGS PKWY STE 510
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64153-1389
Country	:	US
Telephone Number	:	605-660-1211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	05/20/2020

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