Provider Demographics
NPI:1427406131
Name:WILSON, KAITLIN (MS, LCMHC)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:HUTCHINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4041
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302-4041
Mailing Address - Country:US
Mailing Address - Phone:617-819-0914
Mailing Address - Fax:603-628-7757
Practice Address - Street 1:244 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5041
Practice Address - Country:US
Practice Address - Phone:617-819-0914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health