Provider Demographics
NPI:1497004055
Name:FIRTH, KRISTINE E (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:E
Last Name:FIRTH
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 1:85 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-2615
Mailing Address - Country:US
Mailing Address - Phone:646-262-5118
Mailing Address - Fax:
Practice Address - Street 1:85 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2615
Practice Address - Country:US
Practice Address - Phone:646-262-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088249-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical