Provider Demographics
NPI:1942717434
Name:HALLSWORTH, KRISTEN MAYS (MED)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MAYS
Last Name:HALLSWORTH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:4620 N STATE ROAD 7 STE 300
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5867
Mailing Address - Country:US
Mailing Address - Phone:561-323-6593
Mailing Address - Fax:
Practice Address - Street 1:4300 ALEXANDER DR STE 200
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-3780
Practice Address - Country:US
Practice Address - Phone:561-323-6593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst