Individual provider Active NPI

Kristina L Wiley, LPC

  • Mental Health Counselor
  • Huntington, WV
National Provider Identifier
1104024215
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1844 Issued in WV
Practice address
55 Donohoe Dr
Huntington, WV 25705-8887
Phone
(304) 525-7851
NPI assigned
Jul 10, 2007
Last updated
May 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1844 WV Primary

Addresses

Primary practice location

55 Donohoe Dr
Huntington, WV 25705-8887

Mailing address

99 Cracker Barrel Dr Ste 100
Barboursville, WV 25504-1650
Phone (304) 525-7851

Other practice location 1

712 Main St
Point Pleasant, WV 25550-1227
Phone (304) 525-7851

Other identifiers 1

IdentifierTypeStateIssuer
1844OtherWVLPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20250630003157 WV Practitioner - Mental Health Counselor 0547773897 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prestera Center for Mental Health Services Inc CurrentSince Apr 15, 2025 Accepting new patients
Prestera Center for Mental Health Services Inc CurrentSince Apr 15, 2025 Accepting new patients

Locations

99 Cracker Barrel Dr
Ste 100
Barboursville, WV 25504
Phone 30452578512514

376 Kenmore Dr
Danville, WV 25053
Phone (304) 369-1930

55 Donohoe Dr
Huntington, WV 25705

712 Main St
Pt Pleasant, WV 25550

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1104024215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CRACKER BARREL DR STE 100",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041650",
            "telephone_number": "304-525-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DONOHOE DR",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257058887",
            "telephone_number": "304-525-7851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 Main St",
            "address_purpose": "LOCATION",
            "city": "Point Pleasant",
            "state": "WV",
            "postal_code": "255501227",
            "country_code": "US",
            "telephone_number": "304-525-7851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "1844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "1844",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.