Provider Demographics
NPI:1962970301
Name:HYMAN, KRISTIN BRIQUEL (LMSW)
Entity type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:BRIQUEL
Last Name:HYMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 ROLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2843
Mailing Address - Country:US
Mailing Address - Phone:516-547-3199
Mailing Address - Fax:
Practice Address - Street 1:3708 91ST ST STE 3A
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7962
Practice Address - Country:US
Practice Address - Phone:718-779-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097501101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool