| Doctor Name: | KRISTIN CARPENTER |
| NPI Number: | 1033594262 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC |
| License Number: | E.1200112 |
| Business Practice Address: | 1426 Center Rd Avon, OH - 440111214 |
| Business Phone Number: | 2168316611 |
| Business Fax Number: | 2164568128 |
| Mailing Address: | 25101 Chagrin Blvd, Suite 100 BEACHWOOD |
| State: | OH |
| Postal Code: | 441225643 |
| Phone Number: | 2168316611 |
| Fax Number: | 2164568128 |
| NPI Enumeration Date: | 07/29/2015 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | E.1200112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |