Provider Demographics
NPI:1871996165
Name:FRICK, KRISTY ANN (MS, CRC, LPC)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:ANN
Last Name:FRICK
Suffix:
Gender:F
Credentials:MS, CRC, LPC
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:ANN
Other - Last Name:FIORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CRC LPC
Mailing Address - Street 1:1 LINE ST, STE 3
Mailing Address - Street 2:
Mailing Address - City:THROOP
Mailing Address - State:PA
Mailing Address - Zip Code:18512
Mailing Address - Country:US
Mailing Address - Phone:570-507-3189
Mailing Address - Fax:
Practice Address - Street 1:1 LINE ST, STE 3
Practice Address - Street 2:
Practice Address - City:THROOP
Practice Address - State:PA
Practice Address - Zip Code:18512
Practice Address - Country:US
Practice Address - Phone:570-507-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-01
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005727101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional