Provider Demographics
NPI:1306265996
Name:DUARTE, KRISTA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:LYNN
Last Name:DUARTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:LYNN
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1167 N MOUNTAINVIEW PASEO
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-4411
Mailing Address - Country:US
Mailing Address - Phone:801-540-1941
Mailing Address - Fax:
Practice Address - Street 1:1167 N MOUNTAINVIEW PASEO
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-4411
Practice Address - Country:US
Practice Address - Phone:801-540-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT89544783-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical