Kristi Ann Weaver

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.009792 Issued in IL

Practice address

2311 S Illinois Ave
Carbondale, IL 62903-5912

Phone

(618) 457-6703

Fax

(618) 549-3734

NPI assigned

Aug 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Kristi Halfond Former name

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Therapeutic Education and Career Services IncGroup PAC ID 1355679010, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristi.weaver.1@23300.direct.athenahealth.com

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.

• Therapeutic, Education, and Career Services, Inc.

  • Counselor
  • Marion, IL
  • NPI 1043631351
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1053669903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 GRAND OAK DR",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015474",
            "telephone_number": "618-534-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 S ILLINOIS AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629035912",
            "telephone_number": "618-457-6703",
            "fax_number": "618-549-3734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 W Market St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617013918",
            "country_code": "US",
            "telephone_number": "309-827-5351",
            "fax_number": "309-829-6808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KRISTI",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009792",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.009792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTI",
            "last_name": "HALFOND",
            "prefix": "MRS.",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Ward, MD
• Hilda Antranette Watkins-Williams, MD
• Rachel Watson, OTR/L
• Jessica Ann Watts, PTA
• Gayla Joy Wayman, CNM
• Kelli Webb, MD
• Aireal Dee Weber, M.A.
• Joan Alice Weber
• Candace Ilene Weingart, MA, LMHC
• Paul Fredric Weinhold, D.MIN. LCPC

• Mental Health Counselor in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.