Provider Demographics
NPI:1699030437
Name:KRISTEN MENZEL, LPC
Entity Type:Organization
Organization Name:KRISTEN MENZEL, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:254-734-6133
Mailing Address - Street 1:240 E RENFRO ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3938
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:240 E RENFRO ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3938
Practice Address - Country:US
Practice Address - Phone:254-734-6133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66478101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty