Kaitlyn Jindra, AAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG61056395 Issued in WA

Practice address

10505 W Clearwater Ave
Kennewick, WA 99336-8613

Phone

(509) 378-5553

Fax

(509) 579-4088

NPI assigned

Oct 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Three Rivers Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kennewick, WA
  • NPI 1851755839
  NPD

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1003327867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368613",
            "telephone_number": "509-378-5553",
            "fax_number": "509-579-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10505 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368613",
            "telephone_number": "509-378-5553",
            "fax_number": "509-579-4088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Kern Way",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989026340",
            "country_code": "US",
            "telephone_number": "509-574-3200 x3261",
            "fax_number": "509-574-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 Kern Way",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989026340",
            "country_code": "US",
            "telephone_number": "509-574-3200 x3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JINDRA",
        "first_name": "KAITLYN",
        "name_prefix": "Mrs.",
        "credential": "AAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CB60813620",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61056395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Barbara Johnson, RN

• Mental Health Counselor in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.