Provider Demographics
NPI:1346998697
Name:KRISTINE DENCE LLC
Entity Type:Organization
Organization Name:KRISTINE DENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-935-8388
Mailing Address - Street 1:2115 BOGART RD
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-9529
Mailing Address - Country:US
Mailing Address - Phone:144-093-5838
Mailing Address - Fax:
Practice Address - Street 1:4550 LIBERTY AVE STE 200
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-1910
Practice Address - Country:US
Practice Address - Phone:440-822-0596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty