Provider Demographics
NPI:1477932473
Name:MORAND, KRISTEN L (MA,LPC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:MORAND
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 GADSDEN ST
Mailing Address - Street 2:STE. 204
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-6400
Mailing Address - Country:US
Mailing Address - Phone:803-254-9767
Mailing Address - Fax:803-254-9740
Practice Address - Street 1:1911 GADSDEN ST
Practice Address - Street 2:STE. 204
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-6400
Practice Address - Country:US
Practice Address - Phone:803-254-9767
Practice Address - Fax:803-254-9740
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6103101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional