Provider Demographics
NPI:1477000925
Name:KRISTY HRUBY, LMHP, LADC
Entity Type:Organization
Organization Name:KRISTY HRUBY, LMHP, LADC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HRUBY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP, LADC
Authorized Official - Phone:308-390-5508
Mailing Address - Street 1:1811 W 2ND ST STE 450
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5473
Mailing Address - Country:US
Mailing Address - Phone:308-390-5508
Mailing Address - Fax:308-339-0962
Practice Address - Street 1:4131 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1064
Practice Address - Country:US
Practice Address - Phone:308-390-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025528600Medicaid