MEDICARE: MS. KRISTA L KETCHAM M.ED., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	19645	TX

General Provider Information

NPI Number	:	1538216510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTA L KETCHAM M.ED., LPC

Provider Business Mailing Address
First Line	:	4100 FAIRWAY DR
Second Line	:	SUITE 200
City	:	CARROLLTON
State	:	TX
Zip	:	75010-6525
Country	:	US
Telephone Number	:	214-502-0991
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 FAIRWAY DR
Second Line	:	SUITE 200
City	:	CARROLLTON
State	:	TX
Zip	:	75010-6525
Country	:	US
Telephone Number	:	214-502-0991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	11/02/2011

Similar Medicare Providers

1316944366 — MRS. ALISON JENNIFER TAYLOR OTR/L,CHT,CKTI
Practice Location Address:

4100 FAIRWAY DR , STE 400
CARROLLTON, TX
75010-6525

Practice Phone: 972-394-3325
Practice Fax: 972-394-3326

1528043882 — JIAN WANG MD
Practice Location Address:

4100 FAIRWAY DR , SUITE 300
CARROLLTON, TX
75010-6525

Practice Phone: 972-492-8880
Practice Fax: 972-492-8818

1629054531 — DR. LISA RENEE REZNICK M.D.
Practice Location Address:

4100 FAIRWAY DR , SUITE 120
CARROLLTON, TX
75010-6525

Practice Phone: 972-395-9000
Practice Fax: 972-395-9002

1972527786 — DR. SYED MOHSIN HAIDER D.D.S.
Practice Location Address:

4100 FAIRWAY DR , SUITE 520
CARROLLTON, TX
75010-6525

Practice Phone: 972-939-5439
Practice Fax: 973-939-7022

1508910316 — CHARLES STEVEN MANLEY PH.D.
Practice Location Address:

4100 FAIRWAY DR , STE. 200
CARROLLTON, TX
75010-6525

Practice Phone: 972-221-1741
Practice Fax: 972-428-2043

1982907465 — LISA RENEE REZNICK MD, PA
Practice Location Address:

4100 FAIRWAY DR , SUITE 120
CARROLLTON, TX
75010-6525

Practice Phone: 972-395-9000
Practice Fax: 972-395-9002

Directions to “ MS. KRISTA L KETCHAM M.ED., LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.