Provider Demographics
NPI:1033595079
Name:MARQUEZ, KRISTIN L (LPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:L
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:902 EDMOND ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ST. JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-2762
Mailing Address - Country:US
Mailing Address - Phone:816-364-4300
Mailing Address - Fax:816-279-8148
Practice Address - Street 1:902 EDMOND ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ST. JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-2762
Practice Address - Country:US
Practice Address - Phone:816-364-4300
Practice Address - Fax:816-279-8148
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015026811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional