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NPI Code Detail

MEDICARE: KRISTIN BISHOP MACDERMOTT LMFT

MEDICARE:   KRISTIN BISHOP MACDERMOTT  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC0004736CO
2106H00000XMarriage & Family TherapistLMFT102440CA
3106H00000XMarriage & Family Therapist3950FL

General Provider Information

NPI Number : 1104476902
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN BISHOP MACDERMOTT LMFT
Provider Business Mailing Address
First Line : 46 BERMUDA LAKE DR
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33418-4584
Country : US
Telephone Number : 970-309-5088
Fax Number :
Provider Business Practice Location Address
First Line : 100 VILLAGE SQUARE XING STE 203
Second Line :
City : PALM BEACH GARDENS
State : FL
Zip : 33410-4531
Country : US
Telephone Number : 561-771-4550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2019
Last Update Date : 10/12/2021

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Directions to “ KRISTIN BISHOP MACDERMOTT LMFT” Practice Location

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