Provider Demographics
NPI:1174881676
Name:HOSTMEYER, KRISTEN A (LCSW)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:A
Last Name:HOSTMEYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:A
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:PSC 2 BOX 7473
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09012-0075
Mailing Address - Country:US
Mailing Address - Phone:314-479-2390
Mailing Address - Fax:
Practice Address - Street 1:86 MDG
Practice Address - Street 2:UNIT 3215
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09094
Practice Address - Country:US
Practice Address - Phone:314-479-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO19991379981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical