Provider Demographics
NPI:1578026555
Name:FELAN, KRYSTAL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:
Last Name:FELAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10816 CROWN COLONY DR STE 211
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-1677
Mailing Address - Country:US
Mailing Address - Phone:512-699-0576
Mailing Address - Fax:
Practice Address - Street 1:10816 CROWN COLONY DR STE 211
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-1677
Practice Address - Country:US
Practice Address - Phone:512-699-0576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70129101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional