Provider Demographics
NPI:1245570563
Name:MALDONADO, KRISTINA DEMURO (LPC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:DEMURO
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9023 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-2026
Mailing Address - Country:US
Mailing Address - Phone:215-499-8817
Mailing Address - Fax:
Practice Address - Street 1:100 W MAIN ST STE 340
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2022
Practice Address - Country:US
Practice Address - Phone:484-973-6661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional