Provider Demographics
NPI:1689002016
Name:PECKINS, KRISTINA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:
Last Name:PECKINS
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 1:562 KENSICO CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4159
Mailing Address - Country:US
Mailing Address - Phone:845-641-3032
Mailing Address - Fax:
Practice Address - Street 1:48 BURD ST
Practice Address - Street 2:SUITE 206
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3226
Practice Address - Country:US
Practice Address - Phone:845-641-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health