Provider Demographics
NPI:1093891707
Name:SCOTT-LEIN, KRISTIE LEIGH (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:LEIGH
Last Name:SCOTT-LEIN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 STATE HIGHWAY 320
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-3545
Mailing Address - Country:US
Mailing Address - Phone:607-334-4250
Mailing Address - Fax:607-334-4260
Practice Address - Street 1:263 STATE HIGHWAY 320
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3545
Practice Address - Country:US
Practice Address - Phone:607-334-4250
Practice Address - Fax:607-334-9178
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072741-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA2665Medicare ID - Type Unspecified