Provider Demographics
NPI:1053078030
Name:TOWNSEND, KRISTINE REBECCA (LPC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:REBECCA
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 ABINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-8179
Mailing Address - Country:US
Mailing Address - Phone:636-578-6326
Mailing Address - Fax:
Practice Address - Street 1:1053 CAVE SPRINGS RD STE 203
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6435
Practice Address - Country:US
Practice Address - Phone:636-262-6501
Practice Address - Fax:314-279-0029
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-24
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021047110101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional