Provider Demographics
NPI:1689283251
Name:VERMA, KRISTY (LPCC #13286)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:LPCC #13286
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 NIGHTHAWK CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8347
Mailing Address - Country:US
Mailing Address - Phone:209-638-9544
Mailing Address - Fax:
Practice Address - Street 1:749 NIGHTHAWK CT
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8347
Practice Address - Country:US
Practice Address - Phone:209-638-9544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health