Healthcare Provider Details

I. General information

NPI: 1336693944
Provider Name (Legal Business Name): KRISTIN ATZBERGER HUNT LISWS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24549 DETROIT RD STE 6
WESTLAKE OH
44145-2589
US

IV. Provider business mailing address

PO BOX 660
MENTOR OH
44061-0660
US

V. Phone/Fax

Practice location:
  • Phone: 216-496-1255
  • Fax:
Mailing address:
  • Phone: 440-854-0217
  • Fax: 440-516-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTIN ATZBERGER HUNT
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LISWS
Phone: 216-496-1255