Provider Demographics
NPI:1881949428
Name:WHITEHEAD, KRISTINA (LMFT-A)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 TIMBERLOCH PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1150
Mailing Address - Country:US
Mailing Address - Phone:713-409-8450
Mailing Address - Fax:281-901-5325
Practice Address - Street 1:2203 TIMBERLOCH PL
Practice Address - Street 2:SUITE 100
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1150
Practice Address - Country:US
Practice Address - Phone:713-409-8450
Practice Address - Fax:281-901-5325
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201857106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist