Provider Demographics
NPI:1952713471
Name:KNABENSHUE, KRISTINA (LCPC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:KNABENSHUE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04654-0802
Mailing Address - Country:US
Mailing Address - Phone:207-598-5957
Mailing Address - Fax:207-422-7315
Practice Address - Street 1:89 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-1200
Practice Address - Country:US
Practice Address - Phone:207-598-5957
Practice Address - Fax:207-422-7315
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4719101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health