Provider Demographics
NPI:1992839898
Name:CIESIELSKI, KRISTINA SUZANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:SUZANNE
Last Name:CIESIELSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2927
Mailing Address - Country:US
Mailing Address - Phone:315-703-8700
Mailing Address - Fax:
Practice Address - Street 1:215 WYOMING ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-2927
Practice Address - Country:US
Practice Address - Phone:315-703-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6491101YM0800X
NY007999-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health