Provider Demographics
NPI:1053687244
Name:LUMSDEN, KRISTEN ROSE (MSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ROSE
Last Name:LUMSDEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 GOFF AVE
Mailing Address - Street 2:APARTMENT 4101
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-2994
Mailing Address - Country:US
Mailing Address - Phone:757-469-8811
Mailing Address - Fax:
Practice Address - Street 1:125 GOFF AVE
Practice Address - Street 2:APARTMENT 4101
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-2994
Practice Address - Country:US
Practice Address - Phone:757-469-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2012-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10787104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker