Basic Information
| Provider Information | |||||||||
| NPI: | 1972015980 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLIGER | ||||||||
| FirstName: | KRISTA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA/LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1375 US HIGHWAY 42 SE STE C | ||||||||
| Address2: | |||||||||
| City: | LONDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431409548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7408458652 | ||||||||
| FaxNumber: | 6145030899 | ||||||||
| Practice Location | |||||||||
| Address1: | 1375 US HIGHWAY 42 SE, STE C | ||||||||
| Address2: | |||||||||
| City: | LONDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431409548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7408458652 | ||||||||
| FaxNumber: | 6145030899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2017 | ||||||||
| LastUpdateDate: | 10/31/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C.1700351 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | C.1700351 | 01 | OH | OHIO CSWMFT BOARD | OTHER |