Provider Demographics
NPI:1902505068
Name:DEVITO, KRISTEN LYNN (LPC, ADC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LYNN
Last Name:DEVITO
Suffix:
Gender:F
Credentials:LPC, ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 RIDGECREST LN
Mailing Address - Street 2:
Mailing Address - City:KILLEN
Mailing Address - State:AL
Mailing Address - Zip Code:35645-4484
Mailing Address - Country:US
Mailing Address - Phone:256-483-3377
Mailing Address - Fax:
Practice Address - Street 1:62 RIDGECREST LN
Practice Address - Street 2:
Practice Address - City:KILLEN
Practice Address - State:AL
Practice Address - Zip Code:35645-4484
Practice Address - Country:US
Practice Address - Phone:256-483-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04319101Y00000X
ALADC-1092101YA0400X
ALLPC05327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)