Provider Demographics
NPI:1932867751
Name:WAMSER, KIERSTEN REBECCA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIERSTEN
Middle Name:REBECCA
Last Name:WAMSER
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 1:246 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1082
Mailing Address - Country:US
Mailing Address - Phone:203-217-9050
Mailing Address - Fax:
Practice Address - Street 1:246 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1082
Practice Address - Country:US
Practice Address - Phone:203-217-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT118811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical