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General NPI Number Information
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NPI Number | 1720315005
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Entity Type | Individual
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Provider Name | KRISTIEN HOLLINGSWORTH LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/07/2009
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 1415 GALISTEO ST
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City | SANTA FE
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State | NM
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Zip | 87505-4666
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Country | US
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Telephone | 702-325-7689
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 GALISTEO ST
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City | SANTA FE
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State | NM
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Zip | 87505-4666
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Country | US
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Telephone | 702-325-7689
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4585
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-09368
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17411
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 60084
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | IC611
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6374-C
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License Number State | NV
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