Provider Demographics
NPI:1194710640
Name:BALGE, KRISTI ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ANN
Last Name:BALGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:ANN
Other - Last Name:KRIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2048 LILLY ST
Mailing Address - Street 2:
Mailing Address - City:EAST TROY
Mailing Address - State:WI
Mailing Address - Zip Code:53120-1191
Mailing Address - Country:US
Mailing Address - Phone:262-642-3852
Mailing Address - Fax:
Practice Address - Street 1:1 1/2 W GENEVA ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-1722
Practice Address - Country:US
Practice Address - Phone:262-723-3424
Practice Address - Fax:262-723-8308
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3205125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI13697OtherDEAN CARE
WI40970000OtherCENPATICO
2147306OtherCIGNA
WI282103OtherHEALTH MANG CNTR