MEDICARE: KRISTINES KORNER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1659199826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTINES KORNER PLLC

Provider Business Mailing Address
First Line	:	18018 OVERLOOK LOOP STE 105-2002
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-1882
Country	:	US
Telephone Number	:	210-632-9381
Fax Number	:	239-244-1677

Provider Business Practice Location Address
First Line	:	18018 OVERLOOK LOOP STE 105-2002
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-1882
Country	:	US
Telephone Number	:	210-632-9381
Fax Number	:	239-244-1677

Authorized Official
Title or Position	:	LPC/OWNER
Name	:	KRISTINE BENSON
Credential	:	LPC
Telephone Number	:	210-632-9381

Provider Enumeration Date	:	09/27/2024
Last Update Date	:	04/30/2026

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