Healthcare Provider Details

I. General information

NPI: 1316861347
Provider Name (Legal Business Name): KRISTA GARRETT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 W PETTY RD
MUNCIE IN
47304-2491
US

IV. Provider business mailing address

4511 W PETTY RD
MUNCIE IN
47304-2491
US

V. Phone/Fax

Practice location:
  • Phone: 765-744-9916
  • Fax:
Mailing address:
  • Phone: 765-744-9916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33013638A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: