Provider Demographics
NPI:1619500782
Name:KIRSTEN TEKLITS, LCSW
Entity Type:Organization
Organization Name:KIRSTEN TEKLITS, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KIRSETN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEKLITS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-593-0567
Mailing Address - Street 1:1900 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2232
Mailing Address - Country:US
Mailing Address - Phone:302-622-8804
Mailing Address - Fax:
Practice Address - Street 1:2401 PENNSYLVANIA AVE STE 103A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1428
Practice Address - Country:US
Practice Address - Phone:302-593-0567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty