Individual provider Active NPI

Kristina M Burns, LPCC-S, LICDC

  • Professional Counselor
  • Ironton, OH
National Provider Identifier
1114293842
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0800503 Issued in OH
Practice address
700 Park Ave
Ironton, OH 45638-1502
Phone
(740) 532-1613
Fax
(740) 532-1715
NPI assigned
Mar 27, 2012
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162000 OH
Professional Counselor 101YP2500X E.0800503 OH Primary

Addresses

Primary practice location

700 Park Ave
Ironton, OH 45638-1502

Mailing address

1770 Centenary Rd
Gallipolis, OH 45631-8530
Phone (740) 645-3051

Other practice location 1

347 3rd St
Portsmouth, OH 45662-3810
Phone (740) 285-7384

Other identifiers 1

IdentifierTypeStateIssuer
0213059MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240131003268 OH Practitioner - Mental Health Counselor 1052764511 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.0800503OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mended Reeds Services, Inc. Professional CurrentSince Jan 1, 2024 Accepting new patients
Transcendence Behavioral Health, LLC Addiction (Substance Use Disorder) CurrentSince Apr 14, 2024 Accepting new patients

Locations

700 Park Ave
Ironton, OH 45638
Phone (740) 532-1613

347 3rd St
Portsmouth, OH 45662
Phone (740) 285-7384

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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1114293842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 CENTENARY RD",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318530",
            "telephone_number": "740-645-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PARK AVE",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381502",
            "telephone_number": "740-532-1613",
            "fax_number": "740-532-1715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 3rd St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456623810",
            "country_code": "US",
            "telephone_number": "740-285-7384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "KRISTINA",
        "middle_name": "M",
        "credential": "LPCC-S, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162000",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0800503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0213059",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ironton, OH

Sources for this page

Verify at the official NPI Registry.