Provider Demographics
NPI:1538289418
Name:KINGSBURY, KATHLEEN BURNS (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:BURNS
Last Name:KINGSBURY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1606
Mailing Address - Country:US
Mailing Address - Phone:617-773-2344
Mailing Address - Fax:617-773-0907
Practice Address - Street 1:44 GREENLEAF ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4411
Practice Address - Country:US
Practice Address - Phone:617-773-2344
Practice Address - Fax:617-773-0907
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health