Provider Demographics
NPI:1861818502
Name:KEHL, CRISTINA M (LPC, CSAC)
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:M
Last Name:KEHL
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:M
Other - Last Name:HELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSAC
Mailing Address - Street 1:607 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5923
Mailing Address - Country:US
Mailing Address - Phone:920-739-3235
Mailing Address - Fax:920-731-4796
Practice Address - Street 1:607 W 7TH ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5923
Practice Address - Country:US
Practice Address - Phone:920-739-3235
Practice Address - Fax:920-731-4796
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15458-132101YA0400X
WI5122-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional