Active NPI
Kristi Rae Kinney, LCPC
- Professional Counselor
- Effingham, IL
National Provider Identifier
1053452599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-003504
- Practice address
- 14671 N. Court 5
Effingham, IL 62401 - Phone
- (217) 868-5862
- Fax
- (217) 868-5739
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-003504 | IL | Primary |
Addresses
Primary practice location
14671 N. Court 5
Effingham, IL 62401
Mailing address
14671 N. Court 5
Effingham, IL 62401
Phone (217) 868-5862
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180-003504 | Other | IL | LCPC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 29, 2025 through Nov 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-003504 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1053452599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14671 N. COURT 5",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "62401",
"telephone_number": "217-868-5862",
"fax_number": "217-868-5739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14671 N. COURT 5",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "62401",
"telephone_number": "217-868-5862",
"fax_number": "217-868-5739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNEY",
"first_name": "KRISTI",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-003504",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCPC",
"identifier": "180-003504",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Effingham, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.