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1053721274 NPI number — KRISTINA MONT LCPC, NCC

NPI Number: 1053721274
Health Care Provider/Practitioner: KRISTINA MONT LCPC, NCC

Information about “1053721274” NPI (KRISTINA MONT LCPC, NCC) exists in 1053721274 in HTML format HTML  |  1053721274 in plain Text format TXT  |  1053721274 in PDF (Portable Document Format) PDF  |  1053721274 in an XML format XML  formats.

NPI Number : 1053721274 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053721274",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MONT",
    "FirstName": "KRISTINA",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LCPC, NCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MADIA",
    "OtherFirstName": "KRISTINA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LPC, NCC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "50 MOODY ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SACO",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04072-1536",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "50 MOODY ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SACO",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04072-1536",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-434-3000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/28/2014",
    "LastUpdateDate": "01/06/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "37PC00471100",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "LPC-5489T",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "CC5151",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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