Provider Demographics
NPI:1851611594
Name:MEANY-WALEN, KRISTIN K (PHD, LMHC, RPT-S)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:K
Last Name:MEANY-WALEN
Suffix:
Gender:F
Credentials:PHD, LMHC, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:IA
Mailing Address - Zip Code:50667-9104
Mailing Address - Country:US
Mailing Address - Phone:940-255-9526
Mailing Address - Fax:
Practice Address - Street 1:6315 CHANCELLOR DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6919
Practice Address - Country:US
Practice Address - Phone:940-255-9526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64177101Y00000X
IA001407101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor