| Doctor Name: | KRISTIN BIRCHENOUGH |
| NPI Number: | 1740615103 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 37PC00476400 |
| Business Practice Address: | 134 Fort Lee Rd Ll4 Leonia, NJ - 076052297 |
| Business Phone Number: | 2018739399 |
| Business Fax Number: | 2015485047 |
| Mailing Address: | 192 3rd Ave, Suite 8c WESTWOOD |
| State: | NJ |
| Postal Code: | 076752154 |
| Phone Number: | 2018739399 |
| Fax Number: | |
| NPI Enumeration Date: | 09/04/2013 |
| NPI Last Update Date: | 03/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00476400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |