Provider Demographics
NPI:1124659073
Name:BIELKEVICIUS, KRISTINA SLEKYS (NCSP, LEP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:SLEKYS
Last Name:BIELKEVICIUS
Suffix:
Gender:F
Credentials:NCSP, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 FRANKLIN ST APT B
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4257
Mailing Address - Country:US
Mailing Address - Phone:301-312-1258
Mailing Address - Fax:
Practice Address - Street 1:1618 FRANKLIN ST APT B
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4257
Practice Address - Country:US
Practice Address - Phone:301-312-1258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty