Healthcare Provider Details

I. General information

NPI: 1346774254
Provider Name (Legal Business Name): KHRISTAN SHIELDS-LATULIPPE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 LITTLETON RD STE 1B
WESTFORD MA
01886-3530
US

IV. Provider business mailing address

2 BRANDER CT
AMHERST NH
03031-2144
US

V. Phone/Fax

Practice location:
  • Phone: 603-913-5308
  • Fax:
Mailing address:
  • Phone: 603-423-0248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4410
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: