Individual provider Active NPI

Kristin L Waterfield, M.A., L.C.P.C.

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1134494594
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.008150 Issued in IL
Practice address
230 Martin Ave
Naperville, IL 60540-6536
Phone
(630) 848-1200
Fax
(630) 848-1208
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.008150 IL Primary

Addresses

Primary practice location

230 Martin Ave
Naperville, IL 60540-6536

Mailing address

110 S Washington St Apt 206
Naperville, IL 60540-5684
Phone (630) 862-5715

Other practice location 1

11000 US Highway 34 # 103
Plano, IL 60545-9824
Phone (847) 457-6730 ext. 309

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 Arts

State licenses

LicenseStateTypeSpecialty
180.008150ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills Counseling Services, LLC PastSince Sep 5, 2023 Accepting new patients
Prizm Behavioral Services, PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1134494594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WASHINGTON ST APT 206",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405684",
            "telephone_number": "630-862-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MARTIN AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406536",
            "telephone_number": "630-848-1200",
            "fax_number": "630-848-1208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11000 US Highway 34 # 103",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "IL",
            "postal_code": "605459824",
            "country_code": "US",
            "telephone_number": "847-457-6730 x309",
            "fax_number": "847-485-5617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERFIELD",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.A., L.C.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.