Provider Demographics
NPI:1710406020
Name:WILLIAMS, KRISTINA (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 DOLPHIN CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5619
Mailing Address - Country:US
Mailing Address - Phone:719-321-7003
Mailing Address - Fax:
Practice Address - Street 1:3975 DOLPHIN CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5619
Practice Address - Country:US
Practice Address - Phone:719-321-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001052101YA0400X
COLPC.0014710101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)