Provider Demographics
NPI:1366277675
Name:FERRESE, KRISTIN (LAPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:FERRESE
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10040 VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2576
Mailing Address - Country:US
Mailing Address - Phone:412-607-4347
Mailing Address - Fax:
Practice Address - Street 1:2 EASTGATE AVE
Practice Address - Street 2:
Practice Address - City:MONESSEN
Practice Address - State:PA
Practice Address - Zip Code:15062
Practice Address - Country:US
Practice Address - Phone:724-684-6489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000323101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional