Active NPI
Krystal Sandoval, LMHC
- Counselor
- Owensboro, KY
National Provider Identifier
1043404148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 88241
- Practice address
- 1100 Walnut St
Owensboro, KY 42301-2956 - Phone
- (270) 689-6500
- NPI assigned
- Aug 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 88241 | NM | Primary |
Addresses
Primary practice location
1100 Walnut St
Owensboro, KY 42301-2956
Mailing address
707 Broadway Blvd NE Ste 500
Albuquerque, NM 87102-2367
Phone (505) 268-0701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88241 | NM | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188518400000",
"number": "1043404148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 BROADWAY BLVD NE STE 500",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871022367",
"telephone_number": "505-268-0701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WALNUT ST",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423012956",
"telephone_number": "270-689-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "KRYSTAL",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2007-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NM",
"license": "88241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.