Provider Demographics
NPI:1922887074
Name:GINSBURG, KRISTEN J (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:J
Last Name:GINSBURG
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 DOG TEAM RD APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:VT
Mailing Address - Zip Code:05472-4116
Mailing Address - Country:US
Mailing Address - Phone:802-989-5435
Mailing Address - Fax:
Practice Address - Street 1:MIDDLEBURY COLLEGE
Practice Address - Street 2:14 OLD CHAPEL ROAD
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753
Practice Address - Country:US
Practice Address - Phone:802-443-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health