MEDICARE: KRISTINA KNABENSHUE LCPC

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	101YM0800X	Mental Health Counselor	CC4719	ME

General Provider Information

NPI Number	:	1952713471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA KNABENSHUE LCPC

Provider Business Mailing Address
First Line	:	PO BOX 802
Second Line	:
City	:	MACHIAS
State	:	ME
Zip	:	04654-0802
Country	:	US
Telephone Number	:	207-598-5957
Fax Number	:	207-422-7315

Provider Business Practice Location Address
First Line	:	89 MAIN ST STE D
Second Line	:
City	:	MACHIAS
State	:	ME
Zip	:	04654-1200
Country	:	US
Telephone Number	:	207-598-5957
Fax Number	:	207-422-7315

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

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	08/23/2024

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