Provider Demographics
NPI:1164097713
Name:HARVICK, KRISTIN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HARVICK
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 1:1755 N COLLINS BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3592
Mailing Address - Country:US
Mailing Address - Phone:469-659-1996
Mailing Address - Fax:469-248-3635
Practice Address - Street 1:1755 N COLLINS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3592
Practice Address - Country:US
Practice Address - Phone:469-659-1996
Practice Address - Fax:469-248-3635
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health