Provider Demographics
NPI:1073254983
Name:JAMES, KRISTIAN EDWARD (LMSW)
Entity type:Individual
Prefix:MR
First Name:KRISTIAN
Middle Name:EDWARD
Last Name:JAMES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 MARSTON ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-1844
Mailing Address - Country:US
Mailing Address - Phone:785-307-1573
Mailing Address - Fax:
Practice Address - Street 1:1721 MARSTON ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-1844
Practice Address - Country:US
Practice Address - Phone:785-307-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12002104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker