Provider Demographics
NPI:1487776282
Name:KINZER HOWELL, KRISTAL (LPCC)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:
Last Name:KINZER HOWELL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KRISTAL
Other - Middle Name:
Other - Last Name:FELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10230 GELFAND PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4501
Mailing Address - Country:US
Mailing Address - Phone:513-370-0356
Mailing Address - Fax:505-888-1683
Practice Address - Street 1:10230 GELFAND PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4501
Practice Address - Country:US
Practice Address - Phone:513-370-0356
Practice Address - Fax:505-888-1683
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP2500X
NM0155821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM34707026Medicaid