Provider Demographics
NPI:1366831018
Name:SYMEONIDES, KRYSTAL (PHD, LPC, LSATP)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:SYMEONIDES
Suffix:
Gender:F
Credentials:PHD, LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11059 E BETHANY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2637
Mailing Address - Country:US
Mailing Address - Phone:303-617-2300
Mailing Address - Fax:303-617-2397
Practice Address - Street 1:2529 PROFESSIONAL RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3235
Practice Address - Country:US
Practice Address - Phone:804-864-2273
Practice Address - Fax:844-822-6333
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000651101YA0400X
VA0701011153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)