Provider Demographics
NPI:1528410396
Name:VERRASTRO, KRISTA M (MA, RDT/BCT)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:M
Last Name:VERRASTRO
Suffix:
Gender:F
Credentials:MA, RDT/BCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAIN ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1957
Mailing Address - Country:US
Mailing Address - Phone:443-885-0970
Mailing Address - Fax:
Practice Address - Street 1:301 MAIN ST STE 2D
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-1957
Practice Address - Country:US
Practice Address - Phone:443-885-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374101Y00000X, 101200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor