Individual
KRYSTA VITEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 POLE LINE RD, TWIN FALLS, ID 83301-3035
(208) 308-2021
Mailing address
255 BLUE LAKES BLVD N # 633, TWIN FALLS, ID 83301-5238
(208) 736-5048
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-31959
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558606962
—
ID
Enumeration date
07/23/2013
Last updated
10/07/2025
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