Provider Demographics
NPI:1942786173
Name:AGUERO, KRISTIN (LCSW, MPH)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:AGUERO
Suffix:
Gender:F
Credentials:LCSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 7TH AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6014
Mailing Address - Country:US
Mailing Address - Phone:212-696-1550
Mailing Address - Fax:929-273-7942
Practice Address - Street 1:825 7TH AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6014
Practice Address - Country:US
Practice Address - Phone:212-696-1550
Practice Address - Fax:929-273-7942
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0866311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02850677Medicaid