Provider Demographics
NPI:1760817951
Name:KUNTZ, SARA KRISTEN (LPC)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:KRISTEN
Last Name:KUNTZ
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 1:841 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2513
Mailing Address - Country:US
Mailing Address - Phone:724-771-4410
Mailing Address - Fax:
Practice Address - Street 1:2700 W 21ST ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2972
Practice Address - Country:US
Practice Address - Phone:724-771-4410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007107101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional