Provider Demographics
NPI:1679047286
Name:LUNDQUIST MAHOSKY, KRISTEN (LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:LUNDQUIST MAHOSKY
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 1:400 BROAD ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1500
Mailing Address - Country:US
Mailing Address - Phone:202-957-7108
Mailing Address - Fax:
Practice Address - Street 1:400 BROAD ST STE 1006
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1500
Practice Address - Country:US
Practice Address - Phone:202-957-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC200001816101YM0800X
PAPC016225101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC016225OtherPA BOARD OF SOCIAL WORKERS, MFTS AND PROFESSIONAL COUNSELORS
1098403OtherNATIONAL BOARD OF CERTIFIED COUNSELORS
DCPRC200001816OtherDC BOARD OF PROFESSIONAL COUNSELING