Provider Demographics
NPI:1326820879
Name:MUNN, KRYSTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRYSTEN
Middle Name:
Last Name:MUNN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRYSTEN
Other - Middle Name:
Other - Last Name:CREAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:223 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-1456
Mailing Address - Country:US
Mailing Address - Phone:859-391-3228
Mailing Address - Fax:
Practice Address - Street 1:223 W 12TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071-1456
Practice Address - Country:US
Practice Address - Phone:859-391-3228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2561491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical