Provider Demographics
NPI:1801679261
Name:CREIGHTON, KRISTINA LEE (LGPC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEE
Last Name:CREIGHTON
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 STAGS HEAD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-1448
Mailing Address - Country:US
Mailing Address - Phone:410-703-1775
Mailing Address - Fax:
Practice Address - Street 1:TOWSON MENTAL HEALTH
Practice Address - Street 2:10457 FALLS ROAD
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3614
Practice Address - Country:US
Practice Address - Phone:443-589-2475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health