Provider Demographics
NPI:1598379935
Name:HOOPER, KRISTIN ANN (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANN
Last Name:HOOPER
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 1:2721 COMMONWEALTH CT
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-6440
Mailing Address - Country:US
Mailing Address - Phone:920-540-7383
Mailing Address - Fax:
Practice Address - Street 1:W6144 AEROTECH DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-7503
Practice Address - Country:US
Practice Address - Phone:920-733-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4310101YM0800X
WI8128101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health