Provider Demographics
NPI:1740521202
Name:MCCANN, KIT COSTAS REYES (LMFT)
Entity type:Individual
Prefix:
First Name:KIT
Middle Name:COSTAS REYES
Last Name:MCCANN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 INTERNATIONAL DR STE 157
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-6833
Mailing Address - Country:US
Mailing Address - Phone:603-777-6385
Mailing Address - Fax:603-812-4586
Practice Address - Street 1:200 INTERNATIONAL DR STE 157
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-6833
Practice Address - Country:US
Practice Address - Phone:603-777-6385
Practice Address - Fax:603-812-4586
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000939101Y00000X
NH170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor