Provider Demographics
NPI:1649746926
Name:BATEMAN, KRISTY JANE (MA LPC)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:JANE
Last Name:BATEMAN
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 1:10597 MONTGOMERY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4472
Mailing Address - Country:US
Mailing Address - Phone:513-257-2409
Mailing Address - Fax:513-257-2409
Practice Address - Street 1:10597 MONTGOMERY RD STE 101
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4472
Practice Address - Country:US
Practice Address - Phone:513-257-2409
Practice Address - Fax:513-257-2409
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health