Provider Demographics
NPI:1336693944
Name:KRISTIN ATZBERGER HUNT LISWS LLC
Entity Type:Organization
Organization Name:KRISTIN ATZBERGER HUNT LISWS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ATZBERGER
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:LISWS
Authorized Official - Phone:216-496-1255
Mailing Address - Street 1:PO BOX 660
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44061-0660
Mailing Address - Country:US
Mailing Address - Phone:440-854-0217
Mailing Address - Fax:440-516-3783
Practice Address - Street 1:24549 DETROIT RD STE 6
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2589
Practice Address - Country:US
Practice Address - Phone:216-496-1255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHUSW31581Medicare UPIN