Provider Demographics
NPI:1134498637
Name:GUARINO, KRISTINA LEA (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEA
Last Name:GUARINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LEA
Other - Last Name:SKEENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 COMMUNITY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-8804
Mailing Address - Country:US
Mailing Address - Phone:660-885-8131
Mailing Address - Fax:
Practice Address - Street 1:1272 NE WINDSOR DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5594
Practice Address - Country:US
Practice Address - Phone:816-246-4465
Practice Address - Fax:816-524-7008
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011010774104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1134498637Medicaid