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Provider Information for 1952373243


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KRISTINA L MENZEL LCPC


Sex: Female

NPI: 1952373243
Last Updated: 2021-09-21
Certification Date: 2021-09-21

Details

NameValue
NPI1952373243
Enumeration Date2006-02-02
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1717 FLETCHER ST
PRINCETON, IL 61356-2609
United States

Phone: 815-878-3926 | Fax:
 
Primary Practice Address 530 PARK AVE E
PRINCETON, IL 61356-3901
United States

Phone: 815-876-2004 | Fax:
 
Secondary Practice Address(es)

990 VILLA ST
MOUNTAIN VIEW, CA 94041-1236
United States

Phone: 888-688-9296 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)20206303403John Deere
Other (non-Medicare)215708Com Psych
Other (non-Medicare)361563452Tricare
Other (non-Medicare)623783BCBS ILL
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthIL180001135