Provider Demographics
NPI:1669766309
Name:REIFENRATH, KRISTIN A (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:A
Last Name:REIFENRATH
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 RIVER STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2930
Mailing Address - Country:US
Mailing Address - Phone:802-886-4500
Mailing Address - Fax:802-886-4560
Practice Address - Street 1:49 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:VT
Practice Address - Zip Code:05047-0709
Practice Address - Country:US
Practice Address - Phone:802-295-3031
Practice Address - Fax:802-295-0820
Is Sole Proprietor?:No
Enumeration Date:2011-05-28
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15921041C0700X
VT089.00779921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical