Provider Demographics
NPI:1669986782
Name:LEIGHTY, KRISTA RAE (MFT, LPCC)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:RAE
Last Name:LEIGHTY
Suffix:
Gender:F
Credentials:MFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 PEARL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2112
Mailing Address - Country:US
Mailing Address - Phone:440-845-9011
Mailing Address - Fax:440-845-9013
Practice Address - Street 1:5851 PEARL RD STE 305
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-2112
Practice Address - Country:US
Practice Address - Phone:440-845-9011
Practice Address - Fax:440-845-9013
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.1700042106H00000X
OHE.2001735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist