Provider Demographics
NPI:1699551259
Name:JUISTI, CRISTINA MARIE (LPC)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:JUISTI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 W KING RD APT FI111
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1920
Mailing Address - Country:US
Mailing Address - Phone:484-800-6753
Mailing Address - Fax:
Practice Address - Street 1:1086 W KING RD APT FI111
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1920
Practice Address - Country:US
Practice Address - Phone:484-800-6753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health