Individual provider Active NPI

Kristen Allen, MS, LMHC, MCAP

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1073063558
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH18326 Issued in FL
Practice address
15301 Wall Dr
Fort Myers, FL 33908-2349
Phone
(239) 200-5258
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MH18326 FL Primary

Addresses

Primary practice location

15301 Wall Dr
Fort Myers, FL 33908-2349

Mailing address

15301 Wall Dr
Fort Myers, FL 33908-2349
Phone (239) 200-5258

Other names 1

  • Miss Kristen Nicole Allen Professional name

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 Science

State licenses

LicenseStateTypeSpecialty
MH18326FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1073063558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15301 WALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082349",
            "telephone_number": "239-200-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 WALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082349",
            "telephone_number": "239-200-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KRISTEN",
        "name_prefix": "Miss",
        "credential": "MS, LMHC, MCAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "ALLEN",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "MS, LMHC, MCAP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.