Provider Demographics
NPI:1972170868
Name:HIMMELBERGER, KRYSTLE LEANNE (LPC)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:LEANNE
Last Name:HIMMELBERGER
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 1:2338 VERONA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1847
Mailing Address - Country:US
Mailing Address - Phone:210-717-1845
Mailing Address - Fax:
Practice Address - Street 1:2338 VERONA WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1847
Practice Address - Country:US
Practice Address - Phone:210-717-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78458101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional