Kaitlin Marie Cantrell, MS/LPCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

E.1700002 Issued in OH

Practice address

59 N Dixie Dr Ste C
Vandalia, OH 45377-2067

Phone

(937) 314-1659

Fax

(937) 424-8767

NPI assigned

Apr 19, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Ray of Light Counseling LLC

  • Mental Health Counselor
  • Vandalia, OH
  • NPI 1356796643
  NPD

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1154765204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 VAN ARDEN DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772922",
            "telephone_number": "937-305-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 N DIXIE DR STE C",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772067",
            "telephone_number": "937-314-1659",
            "fax_number": "937-424-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "MS/LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.1700002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217668",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Bryant
• Nikki Bulmahn, CDCA
• Melissa M Burkhardt, CNM
• BZ Healthcare, LLC
• Isaac Lucas Cade, CNP
• Kristina Lu Cappelli
• Michelle Laree Cargle-Adams
• Michele R Carlson, CNM
• Rebecca Caserta, LPC
• Tiffany Castle, FNP-C

• Counselor in Vandalia, OH
• Providers in Vandalia, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.