Provider Demographics
| NPI: | 1194495135 |
|---|---|
| Name: | KP BEHAVIORAL LLC |
| Entity type: | Organization |
| Organization Name: | KP BEHAVIORAL LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER, NP |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | KRISTIN |
| Authorized Official - Middle Name: | P |
| Authorized Official - Last Name: | SOLIMANI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | NP, DNP |
| Authorized Official - Phone: | 972-740-4808 |
| Mailing Address - Street 1: | 12700 HILLCREST RD STE 251 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | DALLAS |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75230-7134 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 972-740-4808 |
| Mailing Address - Fax: | 949-862-3770 |
| Practice Address - Street 1: | 12700 HILLCREST RD STE 251 |
| Practice Address - Street 2: | |
| Practice Address - City: | DALLAS |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75230-7134 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 903-388-8182 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-09-20 |
| Last Update Date: | 2022-08-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Single Specialty |