Provider Demographics
NPI:1487329686
Name:EDWARDS, KRISTEN THOMPSON (PHD, LPC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:THOMPSON
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:MRS
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:622 6TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-2408
Mailing Address - Country:US
Mailing Address - Phone:423-833-8120
Mailing Address - Fax:
Practice Address - Street 1:622 6TH AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-2408
Practice Address - Country:US
Practice Address - Phone:423-833-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013661101YP2500X
TN4824101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health