Provider Demographics
NPI:1821840562
Name:COLE, KRISTINA ELFRIEDE WELLS (LPC-A)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ELFRIEDE WELLS
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:ELFRIEDE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-A
Mailing Address - Street 1:351 EXCHANGE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5846
Mailing Address - Country:US
Mailing Address - Phone:512-402-3037
Mailing Address - Fax:737-309-3690
Practice Address - Street 1:351 EXCHANGE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5846
Practice Address - Country:US
Practice Address - Phone:512-402-3037
Practice Address - Fax:737-309-3690
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94652101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health