Kristy Philistin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

33 Dover St # 209
Brockton, MA 02301-5973

Phone

(508) 690-6069

NPI assigned

Aug 30, 2021

Last updated

Aug 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1023785706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DOVER ST STE 209",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015973",
            "telephone_number": "508-690-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 DOVER ST # 209",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015973",
            "telephone_number": "508-690-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILISTIN",
        "first_name": "KRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kristy@myleadinglight.site",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "33 Dover St # 209",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023015973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Pflanz
• Brendan Phan
• Gayle Elaine Phaneuf, RD
• Raymond Phanor, M.ED
• Ginoux Philemont Bernard
• Anne Phillip, RN
• Dakota Elise Phillips
• Dionte Phillips
• Shannon Phillips
• Phocarlux; Inc.

• Clinical Social Worker in Brockton, MA
• Providers in Brockton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.