Provider Demographics
NPI:1477245686
Name:WERNER, KRESTA KC (MS, MA, LPC, CCST)
Entity Type:Individual
Prefix:
First Name:KRESTA
Middle Name:KC
Last Name:WERNER
Suffix:
Gender:F
Credentials:MS, MA, LPC, CCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 E RIO VERDE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1970
Mailing Address - Country:US
Mailing Address - Phone:520-310-9609
Mailing Address - Fax:
Practice Address - Street 1:3071 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1259
Practice Address - Country:US
Practice Address - Phone:520-344-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional