Provider Demographics
NPI:1629251285
Name:EHRENS, KRISTEN D (LCSW, CASAC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:D
Last Name:EHRENS
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WHITEHILL TER
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1990
Mailing Address - Country:US
Mailing Address - Phone:845-629-8309
Mailing Address - Fax:
Practice Address - Street 1:13 WHITEHILL TER
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1990
Practice Address - Country:US
Practice Address - Phone:845-629-8309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070471-11041C0700X
NY0793991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical