Provider Demographics
NPI:1376776575
Name:DUA, KRISTEN NOEL (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NOEL
Last Name:DUA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 NW TIFFANY SPRINGS PKWY STE 510
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153-1389
Mailing Address - Country:US
Mailing Address - Phone:605-660-1211
Mailing Address - Fax:
Practice Address - Street 1:7505 NW TIFFANY SPRINGS PKWY STE 510
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1389
Practice Address - Country:US
Practice Address - Phone:605-660-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018028295101YP2500X
IL180.007071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional