Provider Demographics
NPI:1831430669
Name:THOMPSON-HUBER, KRISTEN L (LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:THOMPSON-HUBER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1044 LACEY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1051
Mailing Address - Country:US
Mailing Address - Phone:609-276-0608
Mailing Address - Fax:732-349-6702
Practice Address - Street 1:1044 LACEY RD STE 7
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1051
Practice Address - Country:US
Practice Address - Phone:609-276-0608
Practice Address - Fax:732-349-6702
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00480200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional