Provider Demographics
NPI:1912067224
Name:LYNCH-COUTURE, KRISTEN (LMHC, CAGS, MA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:LYNCH-COUTURE
Suffix:
Gender:F
Credentials:LMHC, CAGS, MA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, CAGS, MA
Mailing Address - Street 1:501 ANGELL ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4467
Mailing Address - Country:US
Mailing Address - Phone:401-903-4019
Mailing Address - Fax:
Practice Address - Street 1:501 ANGELL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4467
Practice Address - Country:US
Practice Address - Phone:401-903-4019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC01040101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty