Healthcare Provider Details

I. General information

NPI: 1073652640
Provider Name (Legal Business Name): KRISTEN ANN SPADA SOSA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N FRONT ST
KINGSTON NY
12401-3814
US

IV. Provider business mailing address

PO BOX 623
HIGHLAND NY
12528-0623
US

V. Phone/Fax

Practice location:
  • Phone: 845-275-4920
  • Fax: 888-393-2523
Mailing address:
  • Phone: 845-275-4920
  • Fax: 888-393-2523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number079616-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: