Provider Demographics
NPI:1184172892
Name:LAWLESS, KRISTA SUZANNE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:SUZANNE
Last Name:LAWLESS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-7415
Mailing Address - Country:US
Mailing Address - Phone:971-563-5568
Mailing Address - Fax:
Practice Address - Street 1:20512 SW ROY ROGERS RD STE 150
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9930
Practice Address - Country:US
Practice Address - Phone:971-563-5568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health