Active NPI
Kristell Mayrena Engram, LMFTA
- Marriage & Family Therapist
- Charlotte, NC
National Provider Identifier
1093055220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 8089A
- Practice address
- 8614 Panglemont Dr
Charlotte, NC 28269-2294 - Phone
- (704) 957-5816
- NPI assigned
- Feb 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 8089A | NC | Primary |
Addresses
Primary practice location
8614 Panglemont Dr
Charlotte, NC 28269-2294
Mailing address
8614 Panglemont Dr
Charlotte, NC 28269-2294
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8089A | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1093055220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 PANGLEMONT DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282692294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8614 PANGLEMONT DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282692294",
"telephone_number": "704-957-5816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGRAM",
"first_name": "KRISTELL",
"middle_name": "MAYRENA",
"credential": "LMFTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-25",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "8089A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.