Individual provider Active NPI

Kristen G Socci, M.A.

  • Counselor
  • Wayne, PA
National Provider Identifier
1063823649
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
BH001455 Issued in PA
Practice address
115 Bloomingdale Ave
Wayne, PA 19087-4030
Phone
(484) 887-8385
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counselor 101Y00000X BH001455 PA Primary

Addresses

Primary practice location

115 Bloomingdale Ave
Wayne, PA 19087-4030

Mailing address

3015 Malan Dr
Plymouth Meeting, PA 19462-1920
Phone (484) 362-8785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
BH001455PAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Growth Minded Mental Health PastSince Jul 16, 2023 Accepting new patients
Growth Minded PastSince Jul 16, 2023 Accepting new patients

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1063823649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 MALAN DR",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621920",
            "telephone_number": "484-362-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BLOOMINGDALE AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190874030",
            "telephone_number": "484-887-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCCI",
        "first_name": "KRISTEN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "BH001455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.