Provider Demographics
NPI:1841078532
Name:VALENTINE, KYRSTEN (MFT)
Entity type:Individual
Prefix:
First Name:KYRSTEN
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-3218
Mailing Address - Country:US
Mailing Address - Phone:860-480-0958
Mailing Address - Fax:
Practice Address - Street 1:370 LINWOOD ST # 1949
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1998
Practice Address - Country:US
Practice Address - Phone:860-224-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3148106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist