Provider Demographics
NPI:1982106191
Name:WOJTUNIAK, KRISTEN MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:WOJTUNIAK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:M
Other - Last Name:FERRARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:734 GOULD WAY
Mailing Address - Street 2:
Mailing Address - City:YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11980-2052
Mailing Address - Country:US
Mailing Address - Phone:631-891-9076
Mailing Address - Fax:
Practice Address - Street 1:31 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3477
Practice Address - Country:US
Practice Address - Phone:631-891-9076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-03
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094390104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker