Provider Demographics
NPI:1700955036
Name:SOSTE, KRISTA (LPC10946)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:
Last Name:SOSTE
Suffix:
Gender:F
Credentials:LPC10946
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13660 N. 94TH DRIVE
Mailing Address - Street 2:SUITE C3
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:623-487-7763
Mailing Address - Fax:623-486-8276
Practice Address - Street 1:13660 N 94TH DR
Practice Address - Street 2:SUITE C3
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4836
Practice Address - Country:US
Practice Address - Phone:623-487-7763
Practice Address - Fax:623-486-8276
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC10946OtherTHERAPIST