Individual provider Active NPI

Krystle Kaylee Kreider, LPCC, LCPC

  • Professional Counselor
  • Missoula, MT
National Provider Identifier
1144644709
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
BBH-LCPC-LIC-43090 Issued in MT
Practice address
2875 Tina Ave Ste 106
Missoula, MT 59808-1582
Phone
(406) 552-3587
NPI assigned
Feb 18, 2014
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0181471 NM
Professional Counselor 101YP2500X BBH-LCPC-LIC-43090 MT Primary

Addresses

Primary practice location

2875 Tina Ave Ste 106
Missoula, MT 59808-1582

Mailing address

6315 Lone Moose CT
Florence, MT 59833-6005
Phone (505) 977-5376

Other practice location 1

6315 Lone Moose Ct
Florence, MT 59833-6005
Phone (505) 977-5376

Other identifiers 2

IdentifierTypeStateIssuer
6775241MedicaidNM
0687193MedicaidMT

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
BBH-LCPC-LIC-43090MTMDProfessional Counselor
0181471NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Guiding Path, LLC Professional CurrentSince Oct 1, 2021 Accepting new patients

Locations

2875 Tina Ave
Ste 106
Missoula, MT 59808
Phone (406) 552-3587

Organizations & group practices 1

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1144644709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 LONE MOOSE CT",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "598336005",
            "telephone_number": "505-977-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 TINA AVE STE 106",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081582",
            "telephone_number": "406-552-3587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6315 Lone Moose Ct",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "MT",
            "postal_code": "598336005",
            "country_code": "US",
            "telephone_number": "505-977-5376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREIDER",
        "first_name": "KRYSTLE",
        "middle_name": "KAYLEE",
        "name_prefix": "Mrs.",
        "credential": "LPCC, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0181471",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "BBH-LCPC-LIC-43090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6775241",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0687193",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.