Provider Demographics
NPI:1356177596
Name:KRIEG, CAROL (LPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:KRIEG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 SAN FERNANDO LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2829
Mailing Address - Country:US
Mailing Address - Phone:314-550-0802
Mailing Address - Fax:
Practice Address - Street 1:4012 SAN FERNANDO LN
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-2829
Practice Address - Country:US
Practice Address - Phone:314-550-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005003155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional