Provider Demographics
NPI:1215269501
Name:KENT, CRYSTAL LEA (LPC)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:LEA
Last Name:KENT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6070 STEINER
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-8865
Mailing Address - Country:US
Mailing Address - Phone:830-832-3941
Mailing Address - Fax:
Practice Address - Street 1:6070 STEINER
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-8865
Practice Address - Country:US
Practice Address - Phone:830-832-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63712101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional