Provider Demographics
NPI:1053721274
Name:MONT, KRISTINA (LCPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:MONT
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:MS
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:MADIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:50 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 MOODY ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1536
Practice Address - Country:US
Practice Address - Phone:207-434-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NJ37PC00471100101YP2500X
AZLPC-5489T101YP2500X
MECC5151101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional