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NPI Code Detail

MEDICARE: MRS. KRISTA R. VAVRO LPCC

MEDICARE: MRS. KRISTA R. VAVRO LPCC
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
1101YP2500XProfessional Counselor0811KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1392069OTHERKYBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3VAVROKRSOTHERKYCORPHEALTH AND HUMANA
4337858OTHERKYMHN
522017289OTHERKYCIGNA
6730320000OTHERKYMAGELLAN HEALTH

General Provider Information

NPI Number : 1912024498
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTA R. VAVRO LPCC
Provider Business Mailing Address
First Line : 998 BROOKS INDUSTRIAL RD
Second Line : STE. A
City : SHELBYVILLE
State : KY
Zip : 40065-8154
Country : US
Telephone Number : 502-633-1315
Fax Number : 502-633-1316
Provider Business Practice Location Address
First Line : 998 BROOKS INDUSTRIAL RD
Second Line : STE. A
City : SHELBYVILLE
State : KY
Zip : 40065-8154
Country : US
Telephone Number : 502-633-1315
Fax Number : 502-633-1316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 03/26/2017

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