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General NPI Number Information
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NPI Number | 1700430089
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Entity Type | Individual
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Provider Name | KRISTIN DEVRIES LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | PO BOX 266
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City | DALTON
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State | PA
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Zip | 18414-0266
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Country | US
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Telephone | 631-875-5759
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 266
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City | DALTON
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State | PA
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Zip | 18414-0266
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Country | US
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Telephone | 631-875-5759
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW136388
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License Number State | PA
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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 | CW023691
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License Number State | PA
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