Provider Demographics
NPI:1881862266
Name:CAMPBELL, KRISTIE RENEE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:RENEE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16522 HOUSE HAHL RD STE F4
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1901
Mailing Address - Country:US
Mailing Address - Phone:713-515-1702
Mailing Address - Fax:
Practice Address - Street 1:16522 HOUSE HAHL RD STE F4
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1901
Practice Address - Country:US
Practice Address - Phone:713-515-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health