Active NPI
Cristin Patent, M.S., LMHC, PLADC
- Mental Health Counselor
- Harlan, IA
National Provider Identifier
1174991715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- T-088101
- Practice address
- 1303 Garfield Ave
Harlan, IA 51537-2063 - Phone
- (712) 755-5056
- NPI assigned
- Sep 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10655 | NE | |
| Mental Health Counselor | 101YM0800X | T-088101 | IA | Primary |
Addresses
Primary practice location
1303 Garfield Ave
Harlan, IA 51537-2063
Mailing address
1213 Garfield Ave
Harlan, IA 51537-2057
Phone (712) 755-5056
Other practice location 1
8610 Brentwood Dr
Suite 1
La Vista, NE 68128-3377
Phone (402) 331-3232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174991715 | Medicaid | IA |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10655 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| T-088101 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1174991715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 GARFIELD AVE",
"city": "HARLAN",
"state": "IA",
"postal_code": "515372057",
"telephone_number": "712-755-5056",
"fax_number": "712-755-7143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 GARFIELD AVE",
"city": "HARLAN",
"state": "IA",
"postal_code": "515372063",
"telephone_number": "712-755-5056"
}
],
"practiceLocations": [
{
"address_1": "8610 Brentwood Dr",
"address_2": "Suite 1",
"address_purpose": "LOCATION",
"city": "La Vista",
"state": "NE",
"postal_code": "681283377",
"country_code": "US",
"telephone_number": "402-331-3232",
"fax_number": "402-331-1557",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATENT",
"first_name": "CRISTIN",
"credential": "M.S., LMHC, PLADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "10655",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "T-088101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1174991715",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlan, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.