Basic Information
Provider Information
NPI: 1922359439
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORROW
FirstName: KRISTINA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: CSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1080
Address2:  
City: BURKESVILLE
State: KY
PostalCode: 427171080
CountryCode: US
TelephoneNumber: 2708586655
FaxNumber: 2708584027
Practice Location
Address1: 19 MEDICAL LOOP STE 3
Address2:  
City: WHITLEY CITY
State: KY
PostalCode: 426534382
CountryCode: US
TelephoneNumber: 6063765391
FaxNumber: 6063763326
Other Information
ProviderEnumerationDate: 09/24/2012
LastUpdateDate: 06/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X4017KYY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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