Provider Demographics
NPI:1508359829
Name:FAMILY DYNAMICS LLC
Entity Type:Organization
Organization Name:FAMILY DYNAMICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-873-7907
Mailing Address - Street 1:210 GAYNOR PL
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3644
Mailing Address - Country:US
Mailing Address - Phone:201-873-7907
Mailing Address - Fax:
Practice Address - Street 1:216 DAYTON ST STE 3
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4450
Practice Address - Country:US
Practice Address - Phone:201-978-7585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1609148823OtherPROVIDER NPI