Provider Demographics
NPI:1306087754
Name:SCHOONMAKER-BRYANT, KIRSTEN LEE (LPC)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:LEE
Last Name:SCHOONMAKER-BRYANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2200 SILAS CREEK PKWY
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5000
Mailing Address - Country:US
Mailing Address - Phone:336-722-7300
Mailing Address - Fax:336-722-7311
Practice Address - Street 1:2200 SILAS CREEK PKWY
Practice Address - Street 2:SUITE 1-A
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5000
Practice Address - Country:US
Practice Address - Phone:336-722-7300
Practice Address - Fax:336-722-7311
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC7039101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional