Provider Demographics
NPI:1225876147
Name:KINDER, KRISTA NIKOLE (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:NIKOLE
Last Name:KINDER
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 1:2846 HUNTINGDON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2921
Mailing Address - Country:US
Mailing Address - Phone:240-394-0150
Mailing Address - Fax:
Practice Address - Street 1:2846 HUNTINGDON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2921
Practice Address - Country:US
Practice Address - Phone:240-394-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29569104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker