Provider Demographics
NPI:1841412509
Name:LLOYD, KRISTIN L (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:L
Last Name:LLOYD
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:DR
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:LLOYD-MOUSSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LMHC
Mailing Address - Street 1:6175 HICKORY FLAT HWY STE 110
Mailing Address - Street 2:BOX 347
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-3862
Mailing Address - Country:US
Mailing Address - Phone:678-653-0009
Mailing Address - Fax:
Practice Address - Street 1:157 JUNALUSKA DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3135
Practice Address - Country:US
Practice Address - Phone:678-653-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60428148101YM0800X
171400000X, 174H00000X
GALPC008912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator