Provider Demographics
NPI:1255095469
Name:HAFFORD, KRISTEN (LADC, CCS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HAFFORD
Suffix:
Gender:F
Credentials:LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:ME
Mailing Address - Zip Code:04774-3207
Mailing Address - Country:US
Mailing Address - Phone:207-316-9653
Mailing Address - Fax:
Practice Address - Street 1:1425 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:ME
Practice Address - Zip Code:04774-3207
Practice Address - Country:US
Practice Address - Phone:207-316-9653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECCS8817101YA0400X
MECAC7887101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)