Provider Demographics
NPI:1063520401
Name:DEVRIES, KIT PRISCILLANN (LICSW, PHD)
Entity type:Individual
Prefix:DR
First Name:KIT
Middle Name:PRISCILLANN
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:LICSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2424
Mailing Address - Country:US
Mailing Address - Phone:603-224-5513
Mailing Address - Fax:603-226-3757
Practice Address - Street 1:2 S SPRING ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2424
Practice Address - Country:US
Practice Address - Phone:603-224-5513
Practice Address - Fax:603-226-3757
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH#6041041C0700X
MASW10234561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical