Healthcare Provider Details

I. General information

NPI: 1043921893
Provider Name (Legal Business Name): KRISTEN HILTY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 FORUM BLVD STE 3A
COLUMBIA MO
65203-6661
US

IV. Provider business mailing address

3800 MINT JULEP DR
COLUMBIA MO
65202-4815
US

V. Phone/Fax

Practice location:
  • Phone: 573-446-6290
  • Fax:
Mailing address:
  • Phone: 573-540-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024042890
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: