Individual
CHRISTINA L KIRKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E.0500217-SUPV
OH
101YP2500X
Professional Counselor
Primary
E.0500217-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074861
MEDICAID-ODADAS
OH
01
—
0074946
MEDICAID-ODMH
OH
01
—
01-0693
CARF CERTIFICATION
OH
01
—
H130910
MEDICARE GROUP PTAN
OH
Enumeration date
11/11/2009
Last updated
06/16/2018
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