Provider Demographics
NPI:1275859274
Name:HONSBERGER, KRISTIN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HONSBERGER
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 503
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-0503
Mailing Address - Country:US
Mailing Address - Phone:603-356-4114
Mailing Address - Fax:603-356-4118
Practice Address - Street 1:170 KEARSARGE RD
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5331
Practice Address - Country:US
Practice Address - Phone:603-356-4114
Practice Address - Fax:603-356-4118
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1520104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30428259Medicaid