Provider Demographics
NPI:1992134993
Name:VINCENZES, KRISTIN (PHD, LPC, NCC, ACS)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:VINCENZES
Suffix:
Gender:F
Credentials:PHD, LPC, NCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-6700
Mailing Address - Country:US
Mailing Address - Phone:717-818-5377
Mailing Address - Fax:
Practice Address - Street 1:393 ELDRED ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-2340
Practice Address - Country:US
Practice Address - Phone:717-818-5377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional