Provider Demographics
NPI:1760846661
Name:ST. PIERRE, KRISTEN CONSTANCE (MS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:CONSTANCE
Last Name:ST. PIERRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-5241
Mailing Address - Country:US
Mailing Address - Phone:706-321-9606
Mailing Address - Fax:
Practice Address - Street 1:1220 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-5241
Practice Address - Country:US
Practice Address - Phone:706-571-9128
Practice Address - Fax:706-571-9242
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health