Provider Demographics
NPI:1629533716
Name:CLINE, KRISTIN (MS,LPC,CAADC,BC-TMH)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:CLINE
Suffix:
Gender:F
Credentials:MS,LPC,CAADC,BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 BROAD ST STE 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5478
Mailing Address - Country:US
Mailing Address - Phone:724-221-7484
Mailing Address - Fax:724-972-4207
Practice Address - Street 1:1602 BROAD ST STE 2
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5478
Practice Address - Country:US
Practice Address - Phone:724-221-7484
Practice Address - Fax:724-972-4207
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8912101YA0400X
PACAADC8912101YA0400X
PAPC007629101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA8912OtherCAADC
PAPC007629OtherPA LICENSED PROFESSIONAL COUNSELOR NUMBER
PA2738OtherBC-TMH BOARD CERTIFIED TELEMENTAL HEALTH PROVIDER