Provider Demographics
NPI:1770607640
Name:TOTIN, KRISTINA SUE (MSW,LSW)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:SUE
Last Name:TOTIN
Suffix:
Gender:F
Credentials:MSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BISON ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16262-2203
Mailing Address - Country:US
Mailing Address - Phone:724-355-6566
Mailing Address - Fax:
Practice Address - Street 1:153 BISON ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:PA
Practice Address - Zip Code:16262-2203
Practice Address - Country:US
Practice Address - Phone:724-355-6566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW013054L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA575830Medicaid