Provider Demographics
NPI:1760729594
Name:CARPENTER, KRISTEN M (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 UPHAM DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1250
Mailing Address - Country:US
Mailing Address - Phone:614-685-5602
Mailing Address - Fax:
Practice Address - Street 1:700 ACKERMAN RD
Practice Address - Street 2:SUITE 570
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1559
Practice Address - Country:US
Practice Address - Phone:614-293-2046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional