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Individual

KRISTI CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICDC, LPC

Contact information

Practice address
11821 STATE ROUTE 160, VINTON, OH 45686-9009
(740) 245-3051
Mailing address
11821 STATE ROUTE 160, VINTON, OH 45686-9009
(740) 245-3051

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162235
OH
101YM0800X
Mental Health Counselor
Primary
E.2404007
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0145313
OH
Enumeration date
09/19/2019
Last updated
02/08/2024
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