Provider Demographics
NPI:1295480911
Name:HARRELL, KRISTEN VERONICA (LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:VERONICA
Last Name:HARRELL
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-9533
Mailing Address - Country:US
Mailing Address - Phone:843-245-5966
Mailing Address - Fax:
Practice Address - Street 1:3221 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-9533
Practice Address - Country:US
Practice Address - Phone:843-245-5966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health