Provider Demographics
NPI:1316954613
Name:COMPTON, KRISTA LEIGH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:LEIGH
Last Name:COMPTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WORTHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15784
Mailing Address - Country:US
Mailing Address - Phone:814-856-2800
Mailing Address - Fax:
Practice Address - Street 1:190 W PARK AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2277
Practice Address - Country:US
Practice Address - Phone:814-943-8164
Practice Address - Fax:814-375-0922
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013877104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1385619OtherHIGHMARK BLUE CROSS
PA039343Medicare ID - Type Unspecified