Provider Demographics
NPI:1477705523
Name:MITCHELL, KRISTINE I (ND, LCPC, LMHC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:I
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:ND, LCPC, LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2081 W GRANGE AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9659
Mailing Address - Country:US
Mailing Address - Phone:208-457-1999
Mailing Address - Fax:208-981-3777
Practice Address - Street 1:2081 W GRANGE AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9659
Practice Address - Country:US
Practice Address - Phone:208-457-1999
Practice Address - Fax:208-981-3777
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0015567101YP2500X
ORC5459101YP2500X
UT11265674-6004101YP2500X
IDLCPC-6117101YP2500X, 101Y00000X, 101YM0800X
WALH60246926101YM0800X
MTBBH-LCPC-LIC-38900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor