Provider Demographics
NPI:1568839611
Name:HEARLEY, KRYSTLE ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTLE
Middle Name:ANN
Last Name:HEARLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KRYSTLE
Other - Middle Name:ANN
Other - Last Name:KILMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:3 REAMER ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-2961
Mailing Address - Country:US
Mailing Address - Phone:516-500-1548
Mailing Address - Fax:
Practice Address - Street 1:3 REAMER ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-2961
Practice Address - Country:US
Practice Address - Phone:516-500-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health