Provider Demographics
NPI:1841709151
Name:CROMEENES, KRISTINA (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:CROMEENES
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 FILMORE ST
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-1762
Mailing Address - Country:US
Mailing Address - Phone:618-524-9376
Mailing Address - Fax:
Practice Address - Street 1:1015 FILMORE ST
Practice Address - Street 2:
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960-1762
Practice Address - Country:US
Practice Address - Phone:618-524-9376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2506422101YS0200X
IL2506424103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
2506424OtherSCHOOL SERVICE PERSONNEL