Provider Demographics
NPI:1720496334
Name:FILS-AIME, KRISTY LYNNE (MA, MHC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LYNNE
Last Name:FILS-AIME
Suffix:
Gender:F
Credentials:MA, MHC, LAC
Other - Prefix:MISS
Other - First Name:KRISTY
Other - Middle Name:LYNNE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22-08 ROUTE 208
Mailing Address - Street 2:SUITE 16
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2609
Mailing Address - Country:US
Mailing Address - Phone:201-956-6363
Mailing Address - Fax:201-956-6026
Practice Address - Street 1:41 CENTRAL PARK W
Practice Address - Street 2:SUITE 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6734
Practice Address - Country:US
Practice Address - Phone:201-956-6363
Practice Address - Fax:201-956-6026
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00215100101Y00000X
NYP93644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor