Provider Demographics
NPI:1609592740
Name:LEE, KRISTA ALEXANDRIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:ALEXANDRIA
Last Name:LEE
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 1:1812 MONROE CT
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1486
Mailing Address - Country:US
Mailing Address - Phone:805-208-2701
Mailing Address - Fax:
Practice Address - Street 1:1812 MONROE CT
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1486
Practice Address - Country:US
Practice Address - Phone:805-208-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health