Basic Information
Provider Information
NPI: 1306121272
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAYDEN
FirstName: KRISTIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: T-LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 509 E ELM ST
Address2:  
City: SALINA
State: KS
PostalCode: 674012353
CountryCode: US
TelephoneNumber: 7858250541
FaxNumber: 7858250062
Practice Location
Address1: 1421 W 8TH ST
Address2:  
City: WELLINGTON
State: KS
PostalCode: 671524736
CountryCode: US
TelephoneNumber: 6203266373
FaxNumber: 6203265587
Other Information
ProviderEnumerationDate: 10/11/2011
LastUpdateDate: 10/11/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2306KSY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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