Individual provider Active NPI

Kristin Fickes, LAC

  • Mental Health Counselor
  • Scottsdale, AZ
National Provider Identifier
1114704970
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LAC-21873 Issued in AZ
Practice address
14300 N Northsight Blvd Ste 205
Scottsdale, AZ 85260-3676
Phone
(480) 388-9985
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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 LAC-21873 AZ Primary

Addresses

Primary practice location

14300 N Northsight Blvd Ste 205
Scottsdale, AZ 85260-3676

Mailing address

14300 N Northsight Blvd Ste 205
Scottsdale, AZ 85260-3676
Phone (480) 388-9985

Other names 1

  • Kristin Knight Former 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

State licenses

LicenseStateTypeSpecialty
LAC-21873AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1114704970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 N NORTHSIGHT BLVD STE 205",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603676",
            "telephone_number": "480-388-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 N NORTHSIGHT BLVD STE 205",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603676",
            "telephone_number": "480-388-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICKES",
        "first_name": "KRISTIN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-21873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KNIGHT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.