Provider Demographics
NPI:1437352234
Name:ESTES, KRISTEN GILMORE (LPC,NCC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:GILMORE
Last Name:ESTES
Suffix:
Gender:F
Credentials:LPC,NCC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:GILMORE ESTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC,NCC
Mailing Address - Street 1:12106 GORDON SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-2503
Mailing Address - Country:US
Mailing Address - Phone:804-379-5078
Mailing Address - Fax:
Practice Address - Street 1:703 N COURTHOUSE RD STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-4069
Practice Address - Country:US
Practice Address - Phone:804-794-4482
Practice Address - Fax:804-379-7578
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004136101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional