Provider Demographics
NPI:1376990176
Name:KIPRIZLIS, KATRINA MIKAYLA (LPC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:MIKAYLA
Last Name:KIPRIZLIS
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 1:3301 TREXLER BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3445
Mailing Address - Country:US
Mailing Address - Phone:610-216-7434
Mailing Address - Fax:
Practice Address - Street 1:3301 TREXLER BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-3445
Practice Address - Country:US
Practice Address - Phone:610-216-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-21
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
PAPC007947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional