Provider Demographics
NPI:1073894770
Name:COONCE, KRISTINA L (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:L
Last Name:COONCE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7403 FARMDALE ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:CO
Mailing Address - Zip Code:80530-7142
Mailing Address - Country:US
Mailing Address - Phone:920-420-5575
Mailing Address - Fax:
Practice Address - Street 1:7403 FARMDALE ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:CO
Practice Address - Zip Code:80530-7142
Practice Address - Country:US
Practice Address - Phone:920-420-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013667101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional