Provider Demographics
NPI:1063738896
Name:KENTO, KRISTEN ANN (LPC, NCC, MS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:KENTO
Suffix:
Gender:F
Credentials:LPC, NCC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 LIBERTY AVENUE
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065
Mailing Address - Country:US
Mailing Address - Phone:724-226-3722
Mailing Address - Fax:
Practice Address - Street 1:4934 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2043
Practice Address - Country:US
Practice Address - Phone:814-824-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
PAPC006154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA206234OtherUPMC
PA184265OtherUNISON
PA1210OtherCBHNP
PA424947OtherHEALTH AMERICA
PA1007624160014Medicaid
PA197961OtherHIGHMARK
PA330989OtherVBH
PAHMO2595457OtherAETNA
PAPPO7109257OtherAETNA
PA1000364OtherCCBHO