Provider Demographics
NPI:1508305624
Name:FOSCHI, KRISTIN KETTERING (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:KETTERING
Last Name:FOSCHI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-1947
Mailing Address - Country:US
Mailing Address - Phone:860-399-9249
Mailing Address - Fax:
Practice Address - Street 1:1163 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-1947
Practice Address - Country:US
Practice Address - Phone:860-399-9249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-22
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2231106H00000X
CT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist