| Kristi Anne Irving, MA, LPC, LCPC | |
|
980 Maritime Dr Ste 6, Manitowoc, WI 54220-2962 | |
| (920) 733-2065 | |
| Not Available |
| Full Name | Kristi Anne Irving |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 980 Maritime Dr Ste 6, Manitowoc, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699319160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5339-125 (Wisconsin) | Primary |
| Entity Name | Ccp Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396431714 PECOS PAC ID: 7214394022 Enrollment ID: O20230609002780 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristi Anne Irving, MA, LPC, LCPC 1921 Hidden Hollow Ln, Manitowoc, WI 54220-7166 Ph: (630) 632-8344 | Kristi Anne Irving, MA, LPC, LCPC 980 Maritime Dr Ste 6, Manitowoc, WI 54220-2962 Ph: (920) 733-2065 |
Lana L. Roever, M.S., S.A.C.I.T. Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S. 8th Street, Manitowoc, WI 54221 Phone: 920-683-4230 Fax: 920-683-4908 | |
Mrs. Corrin Laurene Applekamp, MS, LPC-IT, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 Riverview Dr, Manitowoc, WI 54220 Phone: 920-663-1035 | |
Courtney Balthazor, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 Riverview Dr, Manitowoc, WI 54220 Phone: 920-663-1035 Fax: 920-215-4918 | |
Kirstin Duprey, QTT Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4230 | |
Justine Boonperm, Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4251 | |
Nicole Bonin, MSW, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 816 Washington St, Manitowoc, WI 54220 Phone: 920-645-3743 | |
Austin David Lucas, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 926 South 8th Street, Manitowoc, WI 54221 Phone: 920-683-4230 Fax: 920-683-4908 |