Provider Demographics
NPI:1932137320
Name:SHANER, KRISTIN (MA, CAC, CEAP, LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:SHANER
Suffix:
Gender:F
Credentials:MA, CAC, CEAP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GREEN BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3095
Mailing Address - Country:US
Mailing Address - Phone:610-327-2344
Mailing Address - Fax:
Practice Address - Street 1:600 CREEKSIDE DR
Practice Address - Street 2:SUITE 601
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-9204
Practice Address - Country:US
Practice Address - Phone:610-326-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002081101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional