Individual
MRS. KRIS L VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC161651
OH
101YM0800X
Mental Health Counselor
E1700396
OH
101YP2500X
Professional Counselor
Primary
E1700396
OH
261QC1800X
Corporate Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/17/2017
Last updated
07/18/2019
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