Provider Demographics
NPI:1346689346
Name:VOGT, KRISTEN (CCLS,MT-BC,LPC,NCC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:VOGT
Suffix:
Gender:F
Credentials:CCLS,MT-BC,LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:EAST TEXAS
Mailing Address - State:PA
Mailing Address - Zip Code:18046-0214
Mailing Address - Country:US
Mailing Address - Phone:484-707-9708
Mailing Address - Fax:
Practice Address - Street 1:6735 CETRONIA RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9202
Practice Address - Country:US
Practice Address - Phone:484-707-9708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-23
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10239225A00000X
PAPC018108101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist