Provider Demographics
NPI:1376116996
Name:THORNELL, CRISTINA (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:THORNELL
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:MARTINEZ-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:3016 INDEPENDENCE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4478
Mailing Address - Country:US
Mailing Address - Phone:830-402-5890
Mailing Address - Fax:
Practice Address - Street 1:3016 INDEPENDENCE DR STE 105
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4478
Practice Address - Country:US
Practice Address - Phone:830-402-5890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75868101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health