Provider Demographics
NPI:1942337845
Name:PERRYMAN, KRISTI (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:PERRYMAN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 S FARM ROAD 205
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-6506
Mailing Address - Country:US
Mailing Address - Phone:417-890-5688
Mailing Address - Fax:417-882-5517
Practice Address - Street 1:1736 E SUNSHINE ST
Practice Address - Street 2:SUITE 811
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1343
Practice Address - Country:US
Practice Address - Phone:417-882-4485
Practice Address - Fax:417-882-5517
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000146857101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional