Provider Demographics
NPI:1962753491
Name:NAUERT, KARISSA MONIQUE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARISSA
Middle Name:MONIQUE
Last Name:NAUERT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 W INTERSTATE 10 STE 626
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3868
Mailing Address - Country:US
Mailing Address - Phone:210-900-0252
Mailing Address - Fax:210-703-9155
Practice Address - Street 1:8000 W INTERSTATE 10 STE 626
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3868
Practice Address - Country:US
Practice Address - Phone:210-900-0252
Practice Address - Fax:210-703-9155
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
TX37762103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist