Provider Demographics
NPI:1679953855
Name:KRISTEN'S COUNSELING, LLC
Entity Type:Organization
Organization Name:KRISTEN'S COUNSELING, LLC
Other - Org Name:KRISTEN'S COUNSELING SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HYMER
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW 4271
Authorized Official - Phone:785-914-9498
Mailing Address - Street 1:2035 E IRON AVE
Mailing Address - Street 2:STE 233
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3433
Mailing Address - Country:US
Mailing Address - Phone:785-914-9498
Mailing Address - Fax:
Practice Address - Street 1:2035 E IRON AVE
Practice Address - Street 2:STE 233
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3433
Practice Address - Country:US
Practice Address - Phone:785-914-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS42711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200672050BMedicaid