Provider Demographics
NPI:1386313310
Name:KRISTIN MOUNT, PLC
Entity type:Organization
Organization Name:KRISTIN MOUNT, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:802-999-3902
Mailing Address - Street 1:11 SANDALWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7828
Mailing Address - Country:US
Mailing Address - Phone:802-355-7741
Mailing Address - Fax:
Practice Address - Street 1:11 SANDALWOOD RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7828
Practice Address - Country:US
Practice Address - Phone:802-355-7741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty