Provider Demographics
NPI:1104507938
Name:LIMONE, KRISTINA ANNE (MHC-LP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANNE
Last Name:LIMONE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12051-1610
Mailing Address - Country:US
Mailing Address - Phone:518-752-1306
Mailing Address - Fax:
Practice Address - Street 1:37 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12051-1610
Practice Address - Country:US
Practice Address - Phone:518-752-1306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP123499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health