Provider Demographics
NPI:1366297996
Name:HERR, KRISTIE (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:HERR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7196 N PLUM TREE UNIT 321
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33955-1119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1720 EL JOBEAN RD UNIT 202
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1279
Practice Address - Country:US
Practice Address - Phone:941-524-2673
Practice Address - Fax:941-240-9027
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health