Healthcare Provider Details

I. General information

NPI: 1134811458
Provider Name (Legal Business Name): KRISTEN HOLLAS HARELSON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN HOLLAS

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 GOODWOOD BLVD STE 200
BATON ROUGE LA
70806-7851
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-6346
  • Fax: 225-765-8585
Mailing address:
  • Phone: 225-765-6346
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1704
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: