Provider Demographics
NPI:1932524402
Name:CARON, KRISTEN LORANGE (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LORANGE
Last Name:CARON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 A ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1970
Mailing Address - Country:US
Mailing Address - Phone:541-324-7521
Mailing Address - Fax:
Practice Address - Street 1:565 HENLEY WAY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3119
Practice Address - Country:US
Practice Address - Phone:541-324-7521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC3947OtherSTATE LICENSE NUMBER
OR500703944Medicaid