Provider Demographics
NPI:1235165655
Name:OSTBERG, KRISTIN W (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:W
Last Name:OSTBERG
Suffix:
Gender:F
Credentials:LMHC
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 121
Mailing Address - Street 2:
Mailing Address - City:STILL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:01467-0121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 STILL RIVER RD.
Practice Address - Street 2:
Practice Address - City:STILL RIVER
Practice Address - State:MA
Practice Address - Zip Code:01467-0121
Practice Address - Country:US
Practice Address - Phone:978-456-3594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4727101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health