Provider Demographics
NPI:1053818773
Name:FURIA, KRISTINA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:FURIA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 WALNUT ST STE 303
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3402
Mailing Address - Country:US
Mailing Address - Phone:215-603-7336
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST STE 303
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3402
Practice Address - Country:US
Practice Address - Phone:215-603-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional