Provider Demographics
NPI:1235331927
Name:WELLS, KRISTEN (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6232
Mailing Address - Country:US
Mailing Address - Phone:508-992-1500
Mailing Address - Fax:
Practice Address - Street 1:842 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6232
Practice Address - Country:US
Practice Address - Phone:508-992-1500
Practice Address - Fax:508-994-0745
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health