Provider Demographics
NPI:1891071684
Name:SPEIER, KRYSTAL LANE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:LANE
Last Name:SPEIER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MISS
Other - First Name:KRYSTAL
Other - Middle Name:LANE
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:110 E POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3306
Mailing Address - Country:US
Mailing Address - Phone:913-397-6666
Mailing Address - Fax:913-397-0066
Practice Address - Street 1:110 E POPLAR ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3306
Practice Address - Country:US
Practice Address - Phone:913-397-6666
Practice Address - Fax:913-397-0066
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health