Healthcare Provider Details

I. General information

NPI: 1255002630
Provider Name (Legal Business Name): KRISTYN MARIE ADLER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 CENTRAL ST STE 101
FRANKLIN NH
03235-2053
US

IV. Provider business mailing address

52 HOYT RD
GILFORD NH
03249-7574
US

V. Phone/Fax

Practice location:
  • Phone: 603-934-1464
  • Fax:
Mailing address:
  • Phone: 603-556-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number089.0113305
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3099
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: