Provider Demographics
NPI:1679464036
Name:BOURDON, KRISTIN MARYE
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARYE
Last Name:BOURDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WEST ST STE L2
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5790
Mailing Address - Country:US
Mailing Address - Phone:413-770-9686
Mailing Address - Fax:
Practice Address - Street 1:66 WEST ST STE L2
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5790
Practice Address - Country:US
Practice Address - Phone:413-770-9686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health