Individual provider Active NPI

Kristina Ann Gillette

  • Mental Health Counselor
  • Malone, NY
National Provider Identifier
1174048318
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
31 6TH St
Malone, NY 12953-1246
Phone
(518) 651-2708
Fax
(518) 483-3383
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

31 6TH St
Malone, NY 12953-1246

Mailing address

PO Box 608
Malone, NY 12953-0608
Phone (518) 483-8729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240930000315 NY Practitioner - Mental Health Counselor 1759812977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Citizen Advocates, IncGroup PAC ID 0648241976, 50 clinicians

Practice addresses (Care Compare)

31 6TH St
Malone, NY 12953-1246
Phone (518) 483-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Advocates, Inc CurrentSince Aug 30, 2024 Accepting new patients
Citizen Advocates, Inc CurrentSince Aug 14, 2022 Accepting new patients

Locations

31 6th St
Malone, NY 12953
Phone (518) 651-2254

15 Francis St
Malone, NY 12953
Phone (518) 483-7801

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1174048318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129530608",
            "telephone_number": "518-483-8729",
            "fax_number": "518-483-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 6TH ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531246",
            "telephone_number": "518-651-2708",
            "fax_number": "518-483-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "KRISTINA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.