Individual provider Active NPI

Kristen M Kansiewicz

  • Mental Health Counselor
  • Lynn, MA
National Provider Identifier
1053428722
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
113 Chestnut St
Lynn, MA 01902-2910
Phone
(781) 367-2383
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

113 Chestnut St
Lynn, MA 01902-2910

Mailing address

126 Oxford St
Apt.205
Lynn, MA 01901-1113
Phone (781) 367-2383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MA2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240209000473 MO Practitioner - Mental Health Counselor 4789027442 Reassigns benefits to 1 organization
I20250715002265 MA Practitioner - Mental Health Counselor 4789027442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Jun 6, 2025 Accepting new patients
Church Therapy Associates, LLC Current Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

4625 Lindell Blvd
Ste 200
Saint Louis, MO 63108
Phone (314) 833-8765

Networks

  • IA HMO
  • IA HMO C-SNP

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053428722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 OXFORD ST",
            "address_2": "APT.205",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011113",
            "telephone_number": "781-367-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CHESTNUT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019022910",
            "telephone_number": "781-367-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANSIEWICZ",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.