Provider Demographics
NPI:1346774544
Name:CANNING-LEE, KRISTI LYNN (MS, LMHCA)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNN
Last Name:CANNING-LEE
Suffix:
Gender:F
Credentials:MS, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 OFFICERS ROW
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3845
Mailing Address - Country:US
Mailing Address - Phone:360-900-4888
Mailing Address - Fax:509-576-3076
Practice Address - Street 1:752 OFFICERS ROW
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3845
Practice Address - Country:US
Practice Address - Phone:360-900-4888
Practice Address - Fax:360-900-4147
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60756758101YM0800X
WAMC 60504309101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health