Provider Demographics
NPI:1013244532
Name:ALLISON, KRISTALYN KATHRYN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTALYN
Middle Name:KATHRYN
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 FM 758
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2725
Mailing Address - Country:US
Mailing Address - Phone:512-557-0102
Mailing Address - Fax:830-620-1176
Practice Address - Street 1:1985 FM 758
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2725
Practice Address - Country:US
Practice Address - Phone:512-557-0102
Practice Address - Fax:830-620-1175
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51560104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209337901Medicaid