Provider Demographics
NPI:1124403449
Name:KRISTEN HUBER, LLP
Entity Type:Organization
Organization Name:KRISTEN HUBER, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:THOMPSON-HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-276-0608
Mailing Address - Street 1:1044 LACEY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1051
Mailing Address - Country:US
Mailing Address - Phone:609-276-0608
Mailing Address - Fax:
Practice Address - Street 1:1044 LACEY RD STE 7
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1051
Practice Address - Country:US
Practice Address - Phone:609-276-0608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00480200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0443123Medicaid