Provider Demographics
NPI:1528447893
Name:KEYES, KRISTIN (LPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:KEYES
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 1:2200 MARKET ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1530
Mailing Address - Country:US
Mailing Address - Phone:409-762-8636
Mailing Address - Fax:409-938-4849
Practice Address - Street 1:2200 MARKET ST
Practice Address - Street 2:SUITE 600
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-1530
Practice Address - Country:US
Practice Address - Phone:409-762-8636
Practice Address - Fax:409-938-4849
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101YM0800XOtherTAXONOMY CODE