Provider Demographics
NPI:1457611881
Name:EFFAN, KRISTEN (LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:EFFAN
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 1:227 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1952
Mailing Address - Country:US
Mailing Address - Phone:636-321-0101
Mailing Address - Fax:636-296-0102
Practice Address - Street 1:1817 GRAVOIS RD
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2668
Practice Address - Country:US
Practice Address - Phone:636-376-0079
Practice Address - Fax:636-677-8440
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator