Healthcare Provider Details

I. General information

NPI: 1255627642
Provider Name (Legal Business Name): KRISTEN L. HUMBER MS, LMHC, ED.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 10/12/2026
Certification Date: 10/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ECHO AVE
BEVERLY MA
01915-2417
US

IV. Provider business mailing address

17 FLINT ST
NORTH READING MA
01864-2805
US

V. Phone/Fax

Practice location:
  • Phone: 781-844-2892
  • Fax:
Mailing address:
  • Phone: 781-844-2892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7474
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: