Provider Demographics
NPI:1346958592
Name:HERZIG, KRISTIN (LPCA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:HERZIG
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4018
Mailing Address - Country:US
Mailing Address - Phone:860-983-1618
Mailing Address - Fax:
Practice Address - Street 1:133 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-2084
Practice Address - Country:US
Practice Address - Phone:860-698-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional