Provider Demographics
NPI:1710873435
Name:RUTLAND, KRISTIN SARAH (MS LPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:SARAH
Last Name:RUTLAND
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 WRIGHTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-9176
Mailing Address - Country:US
Mailing Address - Phone:803-522-5659
Mailing Address - Fax:
Practice Address - Street 1:1824 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:GRANITEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29829-4032
Practice Address - Country:US
Practice Address - Phone:800-552-4357
Practice Address - Fax:678-388-9244
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional