Provider Demographics
NPI:1467087759
Name:ANDAYA, KRISTINA (LCPC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:ANDAYA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 W ARBY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-5108
Mailing Address - Country:US
Mailing Address - Phone:702-626-1072
Mailing Address - Fax:800-380-5190
Practice Address - Street 1:8879 W FLAMINGO RD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8732
Practice Address - Country:US
Practice Address - Phone:702-626-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP5541101YM0800X
NVMI1272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health