Provider Demographics
NPI:1619196896
Name:SCARLETT, KRISTEN (MA, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:SCARLETT
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W 16TH ST
Mailing Address - Street 2:APT. 1CS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 W 16TH ST
Practice Address - Street 2:APT. 1CS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6328
Practice Address - Country:US
Practice Address - Phone:201-400-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18002679101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health