Healthcare Provider Details

I. General information

NPI: 1619256260
Provider Name (Legal Business Name): KRISTIN M. PARENT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BOSTON MEDICAL CENTER PLACE
BOSTON MA
02118
US

IV. Provider business mailing address

720 HARRISON AVE DOB 503
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-5245
  • Fax: 617-414-5520
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9205
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: