Provider Demographics
NPI:1447664180
Name:KRIS ELDRIDGE, LPC
Entity type:Organization
Organization Name:KRIS ELDRIDGE, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-499-3542
Mailing Address - Street 1:2045 S VINEYARD
Mailing Address - Street 2:SUITE 139
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-6889
Mailing Address - Country:US
Mailing Address - Phone:602-499-3542
Mailing Address - Fax:480-718-8762
Practice Address - Street 1:2045 S VINEYARD
Practice Address - Street 2:SUITE 139
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6889
Practice Address - Country:US
Practice Address - Phone:602-499-3542
Practice Address - Fax:480-718-8762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15142251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health