Kristy Bazzanella, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701006594 Issued in VA

Practice address

315 Johnny Hall Rd
Mineral, VA 23117-5202

Phone

(540) 604-3267

Fax

(844) 480-1755

NPI assigned

May 7, 2016

Last updated

Sep 17, 2016By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Louisa Creative Counseling, LLC

  • Mental Health Counselor
  • Mineral, VA
  • NPI 1225484348
  Medicare reassignment NPD Authorized official
• Louisa Creative Counseling, LLC

  • Mental Health Counselor
  • Mineral, VA
  • NPI 1700337078
  NPD Authorized official

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

{
    "created_epoch": "1462579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474070400000",
    "number": "1174979207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7036 ZACHARY TAYLOR HWY",
            "city": "MINERAL",
            "state": "VA",
            "postal_code": "231175312",
            "telephone_number": "540-604-3267",
            "fax_number": "844-480-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 JOHNNY HALL RD",
            "city": "MINERAL",
            "state": "VA",
            "postal_code": "231175202",
            "telephone_number": "540-604-3267",
            "fax_number": "844-480-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZANELLA",
        "first_name": "KRISTY",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-07",
        "last_updated": "2016-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701006594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601092978",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601101224",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahmood Alhajyat
• Katherine Atkinson
• Kelsey C. Beard
• Russell W. Beattie, O.D.
• Emily Berry, PT, DPT
• Cathleen Butler-Cisneros
• Leah Suzanne Choate, CNM

• Mental Health Counselor in Mineral, VA
• Providers in Mineral, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.