Provider Demographics
NPI:1285120881
Name:PULS, KRISTIN NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICOLE
Last Name:PULS
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 1:29 BURNCOAT ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1826
Mailing Address - Country:US
Mailing Address - Phone:303-601-3452
Mailing Address - Fax:
Practice Address - Street 1:34 INSTITUTE RD
Practice Address - Street 2:
Practice Address - City:NORTH GRAFTON
Practice Address - State:MA
Practice Address - Zip Code:01536-1839
Practice Address - Country:US
Practice Address - Phone:508-839-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2213901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical