Provider Demographics
NPI:1114044484
Name:LENTZ, KIRSTEN MARTHE
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARTHE
Last Name:LENTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7705
Mailing Address - Country:US
Mailing Address - Phone:212-838-4333
Mailing Address - Fax:
Practice Address - Street 1:601 W 115TH ST APT 51
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7706
Practice Address - Country:US
Practice Address - Phone:212-665-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker