Provider Demographics
NPI:1841938735
Name:BRAID, KRISTEN ROUTZAHN (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ROUTZAHN
Last Name:BRAID
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3819
Mailing Address - Country:US
Mailing Address - Phone:770-547-3295
Mailing Address - Fax:
Practice Address - Street 1:232 RIVER PARK NORTH DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7834
Practice Address - Country:US
Practice Address - Phone:770-282-7116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0066301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical