Provider Demographics
NPI:1467531640
Name:CARPENTER, KRISTA (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:CARPENTER
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 1:420 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3307
Mailing Address - Country:US
Mailing Address - Phone:970-773-4691
Mailing Address - Fax:952-898-5858
Practice Address - Street 1:420 N 8TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3402
Practice Address - Country:US
Practice Address - Phone:970-773-4691
Practice Address - Fax:970-233-7165
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLCP-000127101Y00000X
CO0005485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor