Provider Demographics
NPI:1841632056
Name:LENZ, KRISTEN MAE (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MAE
Last Name:LENZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-8173
Mailing Address - Country:US
Mailing Address - Phone:727-213-5379
Mailing Address - Fax:727-213-5370
Practice Address - Street 1:1301 SEMINOLE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-8173
Practice Address - Country:US
Practice Address - Phone:727-213-5379
Practice Address - Fax:727-213-5370
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health