Provider Demographics
NPI:1518306711
Name:WESSON, KRISTIN GREEN (LPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:GREEN
Last Name:WESSON
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 1:97 COUNTY ROAD 5131
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-9047
Mailing Address - Country:US
Mailing Address - Phone:662-210-0148
Mailing Address - Fax:
Practice Address - Street 1:97 COUNTY ROAD 5131
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-9047
Practice Address - Country:US
Practice Address - Phone:662-210-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1882101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor