Healthcare Provider Details

I. General information

NPI: 1386554327
Provider Name (Legal Business Name): KRISTEN MARIE WARNER MA, PSY. S, TLLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W ALLEGAN ST
LANSING MI
48933-1783
US

IV. Provider business mailing address

115 W ALLEGAN ST
LANSING MI
48933-1783
US

V. Phone/Fax

Practice location:
  • Phone: 517-489-8556
  • Fax:
Mailing address:
  • Phone: 517-489-8556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6362010180
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: