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General NPI Number Information
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NPI Number | 1013458678
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Entity Type | Individual
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Provider Name | KRISTINE MONIQUE HITCHENS PHD, LCSW-C, LCADC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 539 ROCK SPRING RD
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City | BEL AIR
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State | MD
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Zip | 21014-2940
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Country | US
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Telephone | 443-466-8024
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Fax |
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Provider Business Mailing Address
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Address Line | 296 N SAINT AUGUSTINE RD
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City | CHESAPEAKE CITY
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State | MD
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Zip | 21915-1311
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Country | US
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Telephone | 443-466-8024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCA219
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11558
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License Number State | MD
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