Provider Demographics
NPI:1659078756
Name:VELASQUEZ, KRISTEN (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:VELASQUEZ
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 1:778 MOUNTCASTLE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6581
Mailing Address - Country:US
Mailing Address - Phone:972-754-6770
Mailing Address - Fax:
Practice Address - Street 1:305 N FANNIN ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2558
Practice Address - Country:US
Practice Address - Phone:972-754-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional