Provider Demographics
NPI:1114556578
Name:LUERA, KRISTINA (LPC, LSOTP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:LUERA
Suffix:
Gender:F
Credentials:LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 50TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3515
Mailing Address - Country:US
Mailing Address - Phone:806-809-4661
Mailing Address - Fax:
Practice Address - Street 1:5646 AVENUE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79404-4530
Practice Address - Country:US
Practice Address - Phone:806-775-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77728101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional