Healthcare Provider Details

I. General information

NPI: 1114315827
Provider Name (Legal Business Name): KRISTYN KOWALSKI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2015
Last Update Date: 01/17/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E WASHINGTON ST
NORTH ATTLEBORO MA
02760-6301
US

IV. Provider business mailing address

500 E WASHINGTON ST UNIT 72
NORTH ATTLEBORO MA
02760-6324
US

V. Phone/Fax

Practice location:
  • Phone: 508-905-5704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: