Provider Demographics
NPI:1497372304
Name:MAYFIELD, KRISANN (LPC)
Entity Type:Individual
Prefix:
First Name:KRISANN
Middle Name:
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CUNNINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-4130
Mailing Address - Country:US
Mailing Address - Phone:940-304-3054
Mailing Address - Fax:
Practice Address - Street 1:400 W OAK ST STE 313
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-9092
Practice Address - Country:US
Practice Address - Phone:940-304-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional