Individual provider Active NPI

Kristina Mont, LCPC, NCC

  • Professional Counselor
  • Saco, ME
National Provider Identifier
1053721274
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC5151 Issued in ME
Practice address
50 Moody St
Saco, ME 04072-1536
Phone
(207) 434-3000
NPI assigned
Apr 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 37PC00471100 NJ
Professional Counselor 101YP2500X LPC-5489T AZ
Professional Counselor 101YP2500X CC5151 ME Primary

Addresses

Primary practice location

50 Moody St
Saco, ME 04072-1536

Mailing address

50 Moody St
Saco, ME 04072-1536

Other practice location 1

13395 N Marana Main St
Marana, AZ 85653-7008
Phone (520) 682-4111

Other names 1

  • Ms. Kristina Madia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20240122002384 ME Practitioner - Mental Health Counselor 1557719101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthreach Community Health CentersGroup PAC ID 5496726523, 87 clinicians

Practice addresses (Care Compare)

47 Main St
Cooper Mills, ME 04341
Phone (207) 549-7581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-5489TAZMDProfessional Counselor
CC5151MEMDProfessional Counselor
37PC00471100NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthreach Community Health Centers CurrentSince Jan 1, 2024 Accepting new patients
Healthreach Community Health Centers CurrentSince Jan 1, 2024 Accepting new patients
Marana Health Center, Inc Past Accepting new patients
Marana Health Center, Inc Past Accepting new patients
Sweetser Past Accepting new patients

Locations

4 Clement Way
Belgrade, ME 04917
Phone (207) 660-9924

Organizations & group practices 5

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1053721274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MOODY ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOODY ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721536",
            "telephone_number": "207-434-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13395 N Marana Main St",
            "address_purpose": "LOCATION",
            "city": "Marana",
            "state": "AZ",
            "postal_code": "856537008",
            "country_code": "US",
            "telephone_number": "520-682-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONT",
        "first_name": "KRISTINA",
        "name_prefix": "Mrs.",
        "credential": "LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00471100",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-5489T",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC5151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MADIA",
            "prefix": "MS.",
            "credential": "LPC, NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.