Provider Demographics
NPI:1568834398
Name:KRISTI HOSEK, INC
Entity Type:Organization
Organization Name:KRISTI HOSEK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOSEK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:806-445-4190
Mailing Address - Street 1:6210 102ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8284
Mailing Address - Country:US
Mailing Address - Phone:806-445-4190
Mailing Address - Fax:
Practice Address - Street 1:6500 QUAKER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5100
Practice Address - Country:US
Practice Address - Phone:806-445-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1144558792Medicaid