Individual provider Active NPI

Kiera Elizabeth Kunkel

  • Mental Health Counselor
  • Bloomington, IL
National Provider Identifier
1194055392
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
108 W Market St
Bloomington, IL 61701-3918
Phone
(309) 827-5351
NPI assigned
Jan 11, 2010
Last updated
Jan 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

108 W Market St
Bloomington, IL 61701-3918

Mailing address

612 E Grove St Apt 1E
Bloomington, IL 61701-5366
Phone (480) 460-0168

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Tucson LLC PastSince Nov 5, 2018 Accepting new patients

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": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1194055392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 E GROVE ST APT 1E",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015366",
            "telephone_number": "480-460-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W MARKET ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013918",
            "telephone_number": "309-827-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "KIERA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.