Kristina Bernadette Burks Halliday, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC13861 Issued in ME

Practice address

2 Livewell Dr
Crossroads
Kennebunk, ME 04043

Phone

(207) 467-3369

NPI assigned

Dec 3, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1073858064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MOOSE ROCKS RD",
            "city": "KENNEBUNKPORT",
            "state": "ME",
            "postal_code": "040465260",
            "telephone_number": "207-641-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LIVEWELL DR",
            "address_2": "CROSSROADS",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "04043",
            "telephone_number": "207-467-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIDAY",
        "first_name": "KRISTINA",
        "middle_name": "BERNADETTE BURKS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13861",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pam L Guilbeault, PA-C
• Jennifer Helen Gustafson, OTR/L
• Karlene Hafemann, LCSW
• Theresa T Haggett
• Marcia L Hall, LCPC
• Denise M. Hammond, LCSW
• Laurie L Han, MD
• Katherine A Hanify, D.O.
• Hannaford Bros Co LLC (Hannaford Supermarket & Pharmacy)
• Melissa Joy Hardman, CCC-SLP

• Clinical Social Worker in Kennebunk, ME
• Providers in Kennebunk, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.