Provider Demographics
NPI:1649958919
Name:WELCH, KRISTEN ELISE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELISE
Last Name:WELCH
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 FIREWHEEL DR OFC 103
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2628
Mailing Address - Country:US
Mailing Address - Phone:254-230-4994
Mailing Address - Fax:
Practice Address - Street 1:3535 FIREWHEEL DR OFC 103
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2628
Practice Address - Country:US
Practice Address - Phone:254-230-4994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92041101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional