Provider Demographics
NPI:1427094119
Name:ANDRADE, KRISTEN (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:BATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:151 STATE RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-3516
Mailing Address - Country:US
Mailing Address - Phone:508-971-9893
Mailing Address - Fax:
Practice Address - Street 1:151 STATE RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-3516
Practice Address - Country:US
Practice Address - Phone:508-971-9893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA9398101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health