Provider Demographics
NPI:1518221563
Name:HENDRICKS, KRISTINE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:HENDRICKS
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 1:8955 E PINNACLE PEAK RD STE 99
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3624
Mailing Address - Country:US
Mailing Address - Phone:480-442-7565
Mailing Address - Fax:
Practice Address - Street 1:8955 E PINNACLE PEAK RD STE 99
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3624
Practice Address - Country:US
Practice Address - Phone:480-382-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17043101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional