Provider Demographics
NPI:1194999771
Name:HANKINSON, KRISTAL N (MFT)
Entity type:Individual
Prefix:MISS
First Name:KRISTAL
Middle Name:N
Last Name:HANKINSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2689 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8611
Mailing Address - Country:US
Mailing Address - Phone:859-537-9779
Mailing Address - Fax:502-868-9312
Practice Address - Street 1:2689 FRANKFORT RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8611
Practice Address - Country:US
Practice Address - Phone:859-537-9779
Practice Address - Fax:502-868-9312
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY106485106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid