Provider Demographics
NPI:1740012632
Name:MOEBS, KRISTOPHER WESLEY (LPC)
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:WESLEY
Last Name:MOEBS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 W SOUTH BOUNDARY ST STE A
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5640
Mailing Address - Country:US
Mailing Address - Phone:419-874-3201
Mailing Address - Fax:
Practice Address - Street 1:836 W SOUTH BOUNDARY ST STE A
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5640
Practice Address - Country:US
Practice Address - Phone:419-874-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2406326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional