Provider Demographics
NPI:1437751666
Name:GARAY, KRYSTINE N (LMHC,LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTINE
Middle Name:N
Last Name:GARAY
Suffix:
Gender:F
Credentials:LMHC,LMFT
Other - Prefix:MISS
Other - First Name:KRYSTINE
Other - Middle Name:N
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RMHCI,RMFTI
Mailing Address - Street 1:2500 SW 107TH AVE STE 42
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2492
Mailing Address - Country:US
Mailing Address - Phone:786-615-3334
Mailing Address - Fax:
Practice Address - Street 1:2500 SW 107TH AVE STE 42
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2492
Practice Address - Country:US
Practice Address - Phone:786-615-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty