Provider Demographics
NPI:1831359678
Name:BUTTERFIELD, KIRSTEN (PSYD)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 PELHAM PKWY S
Mailing Address - Street 2:158
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1116
Mailing Address - Country:US
Mailing Address - Phone:718-430-8600
Mailing Address - Fax:
Practice Address - Street 1:1410 PELHAM PKWY S
Practice Address - Street 2:158
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1116
Practice Address - Country:US
Practice Address - Phone:718-430-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017416103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical