Active NPI
Kristy Charnock, LCPC
- Professional Counselor
- Prince Frederick, MD
National Provider Identifier
1194056556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MD
- Practice address
- 422 Solomons Island Rd N
Prince Frederick, MD 20678-3909 - Phone
- (301) 855-1056
- Fax
- (301) 609-7284
- NPI assigned
- Jan 26, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MD | Primary |
Addresses
Primary practice location
422 Solomons Island Rd N
Prince Frederick, MD 20678-3909
Mailing address
PO Box 2924
La Plata, MD 20646-2984
Phone (301) 609-9887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 589561802 | Medicaid | MD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264464000000",
"number": "1194056556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2924",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206462984",
"telephone_number": "301-609-9887",
"fax_number": "301-609-7284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 SOLOMONS ISLAND RD N",
"city": "PRINCE FREDERICK",
"state": "MD",
"postal_code": "206783909",
"telephone_number": "301-855-1056",
"fax_number": "301-609-7284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARNOCK",
"first_name": "KRISTY",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-26",
"last_updated": "2010-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": "MD",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "589561802",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prince Frederick, MD
- Center for Vein Restoration MD LLC
- Centers for Advanced Orthopaedics, LLC
- Centers for Advanced Orthopaedics, LLC
- Mary Chambers-Woodley
- Katherine Anne Chappell, OTR/L
- Foong-Chee Joann Cheah, CRNP
- Ann Chen, PA
- Chesapeake Anesthesia Associates PA
- Chesapeake Eye Care & Laser Center LLC
- Chesapeake Eye Care & Laser Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.