Provider Demographics
NPI:1649325168
Name:TUNE, KRISTINA DIANE (LPCC)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:DIANE
Last Name:TUNE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2978 PLAZA BLANCA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-5340
Mailing Address - Country:US
Mailing Address - Phone:505-992-0282
Mailing Address - Fax:
Practice Address - Street 1:914 BACA ST
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-0972
Practice Address - Country:US
Practice Address - Phone:505-992-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM100645OtherVALUE OPTIONS
NMB8038Medicaid