Provider Demographics
NPI:1679147763
Name:MARSEY, KRISTINA (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:MARSEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 SYCAMORE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2108
Mailing Address - Country:US
Mailing Address - Phone:214-682-0675
Mailing Address - Fax:
Practice Address - Street 1:1402 S CUSTER RD STE 204
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-1452
Practice Address - Country:US
Practice Address - Phone:469-712-9134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67971104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker