Provider Demographics
NPI:1033231899
Name:VAN ESS, KRISTI LEE (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LEE
Last Name:VAN ESS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:LEE
Other - Last Name:MUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:4550 HARTZELL LN APT 3
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-7613
Mailing Address - Country:US
Mailing Address - Phone:715-830-9297
Mailing Address - Fax:
Practice Address - Street 1:2925 MONDOVI RD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6141
Practice Address - Country:US
Practice Address - Phone:715-832-0238
Practice Address - Fax:715-832-0771
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3831-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43594300Medicaid
WI3831-125OtherLPC LICENSE NUMBER
WI114768OtherSECURITY HEALTH PLAN INS