Individual
CHRISTINA KITTSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
6209 E MAIN ST, MARYVILLE, IL 62062-2015
(618) 979-7301
(888) 972-8757
Mailing address
10104 STATE ROUTE 4, LEBANON, IL 62254-2612
(618) 979-7301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180-003952
IL
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06032112
BC/BS OF ILLINOIS
IL
01
—
201674
BC/BS OF MISSOURI
IL
01
—
551406
VALUE OPTIONS
IL
01
—
7431733
AETNA
IL
Enumeration date
08/22/2006
Last updated
03/15/2024
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