Provider Demographics
NPI:1326367129
Name:KIRSCH, KATHLEEN HASSON (LMFT, LPCC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:HASSON
Last Name:KIRSCH
Suffix:
Gender:F
Credentials:LMFT, LPCC
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 1790
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-1790
Mailing Address - Country:US
Mailing Address - Phone:760-845-2032
Mailing Address - Fax:651-400-5351
Practice Address - Street 1:630 ALTA VISTA DR. STE 206
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5506
Practice Address - Country:US
Practice Address - Phone:760-845-2032
Practice Address - Fax:651-400-5351
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34601101YM0800X, 106H00000X
CALMFT34601106H00000X
CALPCC885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional