Provider Demographics
NPI:1134430689
Name:MALDONADO, KRISTEN M (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4331 SW MISTY HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66610-1404
Mailing Address - Country:US
Mailing Address - Phone:315-955-0793
Mailing Address - Fax:
Practice Address - Street 1:4331 SW MISTY HARBOR DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66610-1404
Practice Address - Country:US
Practice Address - Phone:315-955-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health