Krystina Kylene Hannon, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5164-125 Issued in WI

Practice address

1030 Bultman Rd
Madison, WI 53704-8933

Phone

(920) 217-0401

NPI assigned

Jun 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Krystina Kylene Hathaway Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1962840595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 BULTMAN RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537048933",
            "telephone_number": "920-217-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BULTMAN RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537048933",
            "telephone_number": "920-217-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "KRYSTINA",
        "middle_name": "KYLENE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5164-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTINA",
            "last_name": "HATHAWAY",
            "middle_name": "KYLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yousif Hanna, MD
• Hannah Ethun Psychotherapy LLC
• Michael J. Hannaman, M.D.
• Courtney E Hannegan, APNP
• Megan Marie Hannemann, MD
• Matthew R. Hannon, PHARM.D.
• Carolyn Hanold, BSRT
• Autumn Fawne Hansen-Bryant
• Zachary Taylor Hansen-Cole, MD
• Brittany Psensky Hansen, MS

• Mental Health Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.