Kristen Birmingham, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Waterbury, CT

NPI 1699313593 · NPPES record last updated Dec 11, 2019

Key facts

NPI
1699313593
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
000033 (CT)
Practice address
276 Highland Ave
Waterbury, CT 06708-3022
Phone
(860) 302-8671
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000033CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teletherapy Services PLLC Addiction (Substance Use Disorder) Current
since Aug 15, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 000033 CT Yes

Addresses

Primary practice location

276 Highland Ave
Waterbury, CT 06708-3022

Mailing address

46 Barbara Lane
Plantsville, CT 06479
Phone (860) 919-4815

Other providers in Waterbury, CT

All providers in Waterbury, CT · Addiction (Substance Use Disorder) Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.