Provider Demographics
NPI:1225486590
Name:MARCIN, KRISTIN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:MARCIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 TERHUNE RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2312
Mailing Address - Country:US
Mailing Address - Phone:732-609-7290
Mailing Address - Fax:
Practice Address - Street 1:45 TERHUNE RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2312
Practice Address - Country:US
Practice Address - Phone:732-609-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00489500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health