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Kristin Elise Wallace, LMHC

Counselor, Mental Health in St Petersburg, FL. Individual provider (NPI-1).

NPI number1043741069
StatusActive
Last updated in NPPESJul 6, 2023

Details

NPI
1043741069
Entity type
Individual (NPI-1)
Name
Kristin Elise Wallace
Credential
LMHC
Sex
Female
Sole proprietor
No
Enumeration date
Mar 22, 2017
Certification date
Jul 6, 2023
Last updated
Jul 6, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthMH14177FLYes

Practice location

3840 5th Ave N
St Petersburg, FL 33713-7521

Phone 727-732-0864

Mailing address

3840 5th Ave N
St Petersburg, FL 33713-7521

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