Provider Demographics
NPI:1992197727
Name:PATERSON, KRISTY JOANELLE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:JOANELLE
Last Name:PATERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:KRISTY
Other - Middle Name:JOANELLE
Other - Last Name:MOSSBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT-I
Mailing Address - Street 1:225 MEADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-9463
Mailing Address - Country:US
Mailing Address - Phone:805-450-9133
Mailing Address - Fax:
Practice Address - Street 1:8881 M 119
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-9479
Practice Address - Country:US
Practice Address - Phone:231-347-5400
Practice Address - Fax:231-348-2515
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist