Provider Demographics
NPI:1568756997
Name:GEYER, CRISTA M
Entity Type:Individual
Prefix:
First Name:CRISTA
Middle Name:M
Last Name:GEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4139
Mailing Address - Country:US
Mailing Address - Phone:785-628-2871
Mailing Address - Fax:785-628-1438
Practice Address - Street 1:208 E 7TH ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4139
Practice Address - Country:US
Practice Address - Phone:785-628-2871
Practice Address - Fax:785-628-1438
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW-8346104100000X
KST8057104100000X
KSLSCSW-46401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker