Provider Demographics
NPI:1548370976
Name:AUGUSTINE, KRISTIN VANHOUSEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:VANHOUSEN
Last Name:AUGUSTINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MACTANLY PL STE B
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2383
Mailing Address - Country:US
Mailing Address - Phone:540-885-3481
Mailing Address - Fax:540-885-3508
Practice Address - Street 1:100 MACTANLY PL STE B
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2383
Practice Address - Country:US
Practice Address - Phone:540-885-3481
Practice Address - Fax:540-885-3508
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040037281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
084369OtherSOUTHERN HEALTH / SENTARA
174711OtherCOMPSYCH
283034OtherMAMSI
2067108OtherCIGNA
VA318093OtherANTHEM
VAP28229Medicare UPIN