Healthcare Provider Details

I. General information

NPI: 1831873298
Provider Name (Legal Business Name): KRISTINA ALLEN LMSW-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N CENTRAL AVE FL 18
PHOENIX AZ
85004-2322
US

IV. Provider business mailing address

4776 E GUADALUPE RD APT 1006
GILBERT AZ
85234-7582
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW-23466
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: