Provider Demographics
NPI:1831325240
Name:CEJKA, KRISTEN (MASTERS OF SCIENCE)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CEJKA
Suffix:
Gender:F
Credentials:MASTERS OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 390
Mailing Address - Street 2:PROJECT COPE INC
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01903
Mailing Address - Country:US
Mailing Address - Phone:781-581-9270
Mailing Address - Fax:781-581-8413
Practice Address - Street 1:181 UNION STREET,
Practice Address - Street 2:PROJECT COPE INC
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902
Practice Address - Country:US
Practice Address - Phone:781-581-9270
Practice Address - Fax:781-581-8413
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty