Provider Demographics
NPI:1528189586
Name:FLOOD, KRISTENA (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTENA
Middle Name:
Last Name:FLOOD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON ST
Mailing Address - Street 2:PAIN MGT CLINIC
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3487
Mailing Address - Country:US
Mailing Address - Phone:781-278-4566
Mailing Address - Fax:508-674-4626
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:PAIN MGT CLINIC
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3487
Practice Address - Country:US
Practice Address - Phone:781-278-4566
Practice Address - Fax:508-674-4626
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1143501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical