Provider Demographics
NPI:1639984867
Name:MORIN, KIRSTI ELIZABETH (LAC)
Entity type:Individual
Prefix:MS
First Name:KIRSTI
Middle Name:ELIZABETH
Last Name:MORIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2238
Mailing Address - Country:US
Mailing Address - Phone:973-462-9715
Mailing Address - Fax:
Practice Address - Street 1:224 KINGS RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2238
Practice Address - Country:US
Practice Address - Phone:973-462-9715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00792100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional