Provider Demographics
NPI:1053065714
Name:PRESTON, KRISTA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:PRESTON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22760 STONEMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-7700
Mailing Address - Country:US
Mailing Address - Phone:605-484-1574
Mailing Address - Fax:
Practice Address - Street 1:22760 STONEMEADOW RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-7700
Practice Address - Country:US
Practice Address - Phone:605-484-1574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health