Healthcare Provider Details

I. General information

NPI: 1003735911
Provider Name (Legal Business Name): KRISTEN ELIZABETH SMITH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 MAIN ST
HACKENSACK NJ
07601-4858
US

IV. Provider business mailing address

835 MAIN ST
HACKENSACK NJ
07601-4858
US

V. Phone/Fax

Practice location:
  • Phone: 201-678-1802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01290000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: