Provider Demographics
NPI:1134673874
Name:WANSOR, KRISTIN E (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:E
Last Name:WANSOR
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 E LAKE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:16134-4519
Mailing Address - Country:US
Mailing Address - Phone:724-815-6225
Mailing Address - Fax:
Practice Address - Street 1:50 SNYDER RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3432
Practice Address - Country:US
Practice Address - Phone:724-704-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health