Provider Demographics
NPI:1558566562
Name:ANDERSEN, KRIS ANNA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:ANNA
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:SUITE A-200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7762
Mailing Address - Country:US
Mailing Address - Phone:512-415-1207
Mailing Address - Fax:
Practice Address - Street 1:2499 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:SUITE A-200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7762
Practice Address - Country:US
Practice Address - Phone:512-415-1207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional