Healthcare Provider Details

I. General information

NPI: 1073275830
Provider Name (Legal Business Name): KRISTIAN J HUNT LCSW, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 06/26/2022
Certification Date: 06/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 TALMADGE RD STE 831
EDISON NJ
08817-2860
US

IV. Provider business mailing address

180 TALMADGE RD STE 831
EDISON NJ
08817-2860
US

V. Phone/Fax

Practice location:
  • Phone: 908-251-1212
  • Fax:
Mailing address:
  • Phone: 908-251-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06027600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00341700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: