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General NPI Number Information
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NPI Number | 1588152193
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Entity Type | Individual
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Provider Name | KRISTEN F. PIERCE LCPC
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Gender | Female
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 100 WATERMAN DRIVE SUITE 201
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106
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Country | US
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Telephone | 207-799-1331
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Fax | 207-799-1350
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Provider Business Mailing Address
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Address Line | 100 WATERMAN DRIVE SUITE 201
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106
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Country | US
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Telephone | 207-799-1331
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Fax | 207-799-1350
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC4732
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License Number State | ME
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