Individual provider Active NPI

Kristina Erika Malley, MA, NCC, LPC

  • Professional Counselor
  • Phoenixville, PA
National Provider Identifier
1053802181
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC010436 Issued in PA
Practice address
601 Gay St Ste 6
Phoenixville, PA 19460-3852
Phone
(610) 489-3333
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC010436 PA Primary

Addresses

Primary practice location

601 Gay St Ste 6
Phoenixville, PA 19460-3852

Mailing address

601 Gay St Ste 6
Phoenixville, PA 19460-3852
Phone (610) 489-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240918003809 PA Practitioner - Mental Health Counselor 4981145869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1489 Baltimore Pike
Springfield, PA 19064-3958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PC010436PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jul 8, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jul 8, 2024 Accepting new patients
Hopewell Psychology LLC CurrentSince Jun 29, 2026 Accepting new patients
Optum Behavioral Care of Delaware, Inc Past Accepting new patients
Springfield Psychological PC Past Accepting new patients
Penn Psychiatric Center Inc Past Accepting new patients

Locations

1999 Sproul Rd
Ste 23
Broomall, PA 19008
Phone (484) 731-0000

102 Pickering Way
Ste 506
Exton, PA 19341
Phone (856) 472-5092

1489 Baltimore Pike
Ste 250
Springfield, PA 19064
Phone 6105442110144

7 Neshaminy Interplex Dr
Trevose, PA 19053

7 Neshaminy Interplex Dr
Ste 411
Trevose, PA 19053

560 Van Reed Rd
Ste 301
Wyomissing, PA 19610
Phone (610) 378-9601

Interoperability endpoints

  • Direct secure messaging: kristina.malley.1@28623.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GEDIBA

Organizations & group practices 6

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1053802181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GAY ST STE 6",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194603852",
            "telephone_number": "610-489-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GAY ST STE 6",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194603852",
            "telephone_number": "610-489-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLEY",
        "first_name": "KRISTINA",
        "middle_name": "ERIKA",
        "credential": "MA, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenixville, PA

Sources for this page

Verify at the official NPI Registry.