Provider Demographics
NPI:1861802381
Name:MORTON, KRISTIN (LCPC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16241 HARWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-3528
Mailing Address - Country:US
Mailing Address - Phone:301-724-7277
Mailing Address - Fax:301-724-7022
Practice Address - Street 1:155 LOG CANOE CIR
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2127
Practice Address - Country:US
Practice Address - Phone:410-604-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional