Provider Demographics
NPI:1518515055
Name:SLYE, KRISTIN ANN (LMFT AND REAT)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:ANN
Last Name:SLYE
Suffix:
Gender:F
Credentials:LMFT AND REAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 PALISADES DR.
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161
Mailing Address - Country:US
Mailing Address - Phone:530-426-2203
Mailing Address - Fax:
Practice Address - Street 1:UNCOVERY COLLECTIVE
Practice Address - Street 2:10015 DALISADES DR, #5
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161
Practice Address - Country:US
Practice Address - Phone:530-426-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2023-08-25
Deactivation Date:2022-12-13
Deactivation Code:
Reactivation Date:2023-07-13
Provider Licenses
StateLicense IDTaxonomies
CA114317101YM0800X, 106H00000X
CALMFT131189106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health