Provider Demographics
NPI:1003400615
Name:WARNES, KRYSTAL SUZANNE (LPC-CANDIDATE)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:SUZANNE
Last Name:WARNES
Suffix:
Gender:F
Credentials:LPC-CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SEQUOYAH LN STE B-2
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-1756
Mailing Address - Country:US
Mailing Address - Phone:580-379-0203
Mailing Address - Fax:
Practice Address - Street 1:111 SEQUOYAH LN STE B-2
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-1756
Practice Address - Country:US
Practice Address - Phone:580-379-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health