Provider Demographics
NPI:1205183829
Name:MORIN, KRISTEN MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MARIE
Last Name:MORIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2008
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04241-2008
Mailing Address - Country:US
Mailing Address - Phone:207-783-9141
Mailing Address - Fax:207-783-4660
Practice Address - Street 1:1155 LISBON ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5025
Practice Address - Country:US
Practice Address - Phone:207-783-9141
Practice Address - Fax:207-783-4660
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC137141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical