Provider Demographics
NPI:1194536771
Name:KREH, KRISTA (LSW)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:KREH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PORTSMOUTH CIR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-2616
Mailing Address - Country:US
Mailing Address - Phone:484-753-3693
Mailing Address - Fax:
Practice Address - Street 1:142 W MARKET ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-2930
Practice Address - Country:US
Practice Address - Phone:484-753-3693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140727104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty