Provider Demographics
NPI:1174944664
Name:OVERMAN, KRISTIN (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:OVERMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:5714 138TH PL SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208
Mailing Address - Country:US
Mailing Address - Phone:425-215-9106
Mailing Address - Fax:208-664-9217
Practice Address - Street 1:16300 MILL CREEK BLVD
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012
Practice Address - Country:US
Practice Address - Phone:425-215-9106
Practice Address - Fax:208-664-9217
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60634247101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health