Provider Demographics
NPI:1912024332
Name:STEWART, KRISTI KAY (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:KAY
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 US HIGHWAY 277 S
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-9023
Mailing Address - Country:US
Mailing Address - Phone:940-864-3553
Mailing Address - Fax:940-864-5017
Practice Address - Street 1:903 US HIGHWAY 277 S
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:TX
Practice Address - Zip Code:79521-9023
Practice Address - Country:US
Practice Address - Phone:940-864-3553
Practice Address - Fax:940-864-5017
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional