Provider Demographics
NPI:1780379800
Name:MATTHEWS, KRISTINE N (LPCC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:N
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 PANTHER CT
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-9031
Mailing Address - Country:US
Mailing Address - Phone:903-907-0422
Mailing Address - Fax:
Practice Address - Street 1:310 PANTHER CT
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-9031
Practice Address - Country:US
Practice Address - Phone:903-907-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90543101YM0800X
CO0020613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health