Provider Demographics
NPI:1922261627
Name:KIRCHNER, KERSTIN (MPH, LMSW-CC)
Entity Type:Individual
Prefix:
First Name:KERSTIN
Middle Name:
Last Name:KIRCHNER
Suffix:
Gender:F
Credentials:MPH, LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 COLINS MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ALFRED
Mailing Address - State:ME
Mailing Address - Zip Code:04002-3466
Mailing Address - Country:US
Mailing Address - Phone:207-807-0367
Mailing Address - Fax:
Practice Address - Street 1:67 COLINS MEADOW LN
Practice Address - Street 2:
Practice Address - City:ALFRED
Practice Address - State:ME
Practice Address - Zip Code:04002-3466
Practice Address - Country:US
Practice Address - Phone:207-807-0367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2022-11-01
Deactivation Date:2017-10-26
Deactivation Code:
Reactivation Date:2022-10-28
Provider Licenses
StateLicense IDTaxonomies
MEMT1988225700000X
MEMC213071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist