Provider Demographics
NPI:1043748296
Name:HAGERMAN, KRISTIN RENE' (LPCC-S)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:RENE'
Last Name:HAGERMAN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:RENE'
Other - Last Name:SPAULDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S
Mailing Address - Street 1:5665 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-9280
Mailing Address - Country:US
Mailing Address - Phone:614-875-2371
Mailing Address - Fax:
Practice Address - Street 1:5665 HOOVER RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9280
Practice Address - Country:US
Practice Address - Phone:614-875-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1700332101YM0800X
OHE.2001664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health