Provider Demographics
NPI:1942739883
Name:KIRCHNER, TINA MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:TAGGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4304 S. BEARFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201
Mailing Address - Country:US
Mailing Address - Phone:573-874-8686
Mailing Address - Fax:
Practice Address - Street 1:401 E MADISON ST
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MO
Practice Address - Zip Code:65018-1742
Practice Address - Country:US
Practice Address - Phone:573-680-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017017009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional