Provider Demographics
NPI:1154740728
Name:WELTON, KRISTEN ELISE (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELISE
Last Name:WELTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE116
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4183
Mailing Address - Country:US
Mailing Address - Phone:972-964-3214
Mailing Address - Fax:972-964-3044
Practice Address - Street 1:2222 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE116
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4183
Practice Address - Country:US
Practice Address - Phone:972-964-3214
Practice Address - Fax:972-964-3044
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58722104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker