MEDICARE: MISS KRISTEN EDMISTEN 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	2022040756	MO

General Provider Information

NPI Number	:	1467141283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KRISTEN EDMISTEN LPC

Provider Business Mailing Address
First Line	:	PO BOX 902071
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64190-2071
Country	:	US
Telephone Number	:	816-200-7503
Fax Number	:

Provider Business Practice Location Address
First Line	:	3933 NW 85TH TER APT G
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64154-3779
Country	:	US
Telephone Number	:	816-200-7503
Fax Number	:

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	09/03/2025

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