Provider Demographics
NPI:1346629466
Name:CHAMNESS, KRISTIN (LIMHP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:CHAMNESS
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N ELM ST STE 115
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-4509
Mailing Address - Country:US
Mailing Address - Phone:308-380-5719
Mailing Address - Fax:888-508-2370
Practice Address - Street 1:103 E 10TH ST
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-1442
Practice Address - Country:US
Practice Address - Phone:308-284-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3461101YM0800X
NE962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health