Provider Demographics
NPI:1659464519
Name:PAPUCHIS, KRISTIE LYNNE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:LYNNE
Last Name:PAPUCHIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7480 SW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4906
Mailing Address - Country:US
Mailing Address - Phone:301-943-8360
Mailing Address - Fax:
Practice Address - Street 1:7480 SW 14TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4906
Practice Address - Country:US
Practice Address - Phone:301-943-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW126391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical