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General NPI Number Information
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NPI Number | 1992416010
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Entity Type | Organization
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Legal Business Name | KRISTIN PHILLIPS, LMHC
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 411 MAIN ST
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City | YARMOUTH PORT
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State | MA
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Zip | 02675-1843
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Country | US
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Telephone | 617-447-1528
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 972
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City | SOUTH YARMOUTH
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State | MA
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Zip | 02664-0972
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Country | US
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Telephone | 617-447-1528
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN PHILLIPS
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Credential |
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Telephone | 309-506-5277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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