Provider Demographics
NPI:1396344164
Name:MEADE, KRISTI (LPC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:MEADE
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 1:525 CASSIDY RD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4088
Mailing Address - Country:US
Mailing Address - Phone:229-225-3939
Mailing Address - Fax:229-225-5288
Practice Address - Street 1:525 CASSIDY RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4088
Practice Address - Country:US
Practice Address - Phone:229-225-3917
Practice Address - Fax:229-225-5288
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional