Provider Demographics
NPI:1427637636
Name:MEYER, KRISTINA LEE (LCSW, APHSW-C)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEE
Last Name:MEYER
Suffix:
Gender:F
Credentials:LCSW, APHSW-C
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LEE
Other - Last Name:MEYER-ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1060
Mailing Address - Fax:210-261-1821
Practice Address - Street 1:6800 PARK TEN BLVD STE 200S
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4293
Practice Address - Country:US
Practice Address - Phone:210-261-1060
Practice Address - Fax:210-261-1821
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1086651041C0700X
AK1871941041C0700X
IDLCSW416691041C0700X
MTBBHLCSWLIC551351041C0700X
NMC121601041C0700X
ORL83541041C0700X
TX1068111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical