Dr Krystallynne Shanielle Mikle, PHD, LCSW, MSW, BSW is a
Social Worker - Clinical based in Porter, Texas. Dr Krystallynne Shanielle Mikle is licensed to practice in Texas (license number 50664) and her current practice location is
21898 Fm 1314 Road Suite C Pmb 104, Suite C Pmb 104, Porter, Texas. She can be reached at her office (for appointments etc.) via phone at
(832) 556-3079.
NPI number for Dr Krystallynne Shanielle Mikle is 1346995818 and her current mailing address is 21898 Fm 1314 Road, Suite C Pmb 104, Porter, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1346995818.
Healthcare Provider's Profile
| Full Name | Dr Krystallynne Shanielle Mikle |
|---|
| Gender | Female |
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| Speciality | Social Worker - Clinical |
|---|
| Location | 21898 Fm 1314 Road Suite C Pmb 104, Porter, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346995818
- Provider Enumeration Date: 02/14/2022
- Last Update Date: 09/26/2023
Medical Identifiers
Medical identifiers for Dr Krystallynne Shanielle Mikle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346995818 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | 50664 (Texas) | Secondary |
| 101YM0800X | Counselor - Mental Health | 50664 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | 50664 (Texas) | Secondary |
| 104100000X | Social Worker | 50664 (Texas) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 50664 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Krystallynne Shanielle Mikle is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Krystallynne Shanielle Mikle, PHD, LCSW, MSW, BSW
21898 Fm 1314 Road, Suite C Pmb 104,
Porter, TX 77365
Ph: (832) 556-3079 | Dr Krystallynne Shanielle Mikle, PHD, LCSW, MSW, BSW
21898 Fm 1314 Road Suite C Pmb 104, Suite C Pmb 104,
Porter, TX 77365
Ph: (832) 556-3079 |
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