Provider Demographics
NPI:1003324286
Name:HEARON, KRISTA (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:HEARON
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 1:1515 EDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-6339
Mailing Address - Country:US
Mailing Address - Phone:405-938-5786
Mailing Address - Fax:405-948-4933
Practice Address - Street 1:1515 EDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4929
Practice Address - Country:US
Practice Address - Phone:405-938-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health