Provider Demographics
NPI:1871068064
Name:LANDINE, KRISTY (LMHC)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:LANDINE
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 1:49 NURSERY LN
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-3576
Mailing Address - Country:US
Mailing Address - Phone:978-516-5051
Mailing Address - Fax:978-477-8368
Practice Address - Street 1:49 NURSERY LN
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-3576
Practice Address - Country:US
Practice Address - Phone:978-516-5051
Practice Address - Fax:978-477-8368
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA10000723101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor