Kristi Conner Licsw LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LW60225676 Issued in WA

Legal business name

KRISTI CONNER LICSW LLC

Practice address

2209 N 30TH St Ste 1
Tacoma, WA 98403-3352

Phone

(253) 345-1862

Fax

(253) 736-0128

NPI assigned

Mar 8, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristi M Conner, LICSW

Title

Owner

Phone

(253) 345-1862

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristi Conner Counseling Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1588166284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 N 30TH ST STE 1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984033352",
            "telephone_number": "253-345-1862",
            "fax_number": "253-736-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 N 30TH ST STE 1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984033352",
            "telephone_number": "253-345-1862",
            "fax_number": "253-736-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTI CONNER LICSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-345-1862",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WA",
            "license": "LW60225676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790945194",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kristi Conner Counseling",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samakshi Krishna, M.D.
• Bahirathan Krishnadasan, MD
• Yogeshwaran Krishnakumar, MD
• Uma M Krishnan, MD
• Amberly Krist
• Deborah Jean Kristovich, PT
• Joseph Stephen Krivda, MD
• Hans Kroetsch
• Brenna Krogman, OT
• Edith Trites Kroha, ARNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.