Provider Demographics
NPI:1063012532
Name:MARTIN, KRISTIN ELIZABETH (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PINE TOP RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1705
Mailing Address - Country:US
Mailing Address - Phone:508-272-9757
Mailing Address - Fax:
Practice Address - Street 1:575 E MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5528
Practice Address - Country:US
Practice Address - Phone:401-924-3924
Practice Address - Fax:401-619-7766
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health