Provider Demographics
NPI:1003242538
Name:TESSIER, KRISTIN (LICSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:TESSIER
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 SE CROFT CIR APT K-1
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-6348
Mailing Address - Country:US
Mailing Address - Phone:206-399-6113
Mailing Address - Fax:
Practice Address - Street 1:8227 SE CROFT CIR APT K-1
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-6348
Practice Address - Country:US
Practice Address - Phone:206-399-6113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW20184103TC0700X
MA126160103TC0700X
WA00016911225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist