Active NPI
Kendal Gerold
- Mental Health Counselor
- Sarasota, FL
National Provider Identifier
1205401288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC009185
- Practice address
- 12669 Promenade Estates Blvd
Sarasota, FL 34238-3512 - Phone
- (941) 400-5033
- NPI assigned
- May 23, 2021
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC009185 | GA | Primary |
Addresses
Primary practice location
12669 Promenade Estates Blvd
Sarasota, FL 34238-3512
Mailing address
300 Colonial Center Pkwy Ste 100N
Roswell, GA 30076-4892
Phone (770) 999-9479
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC009185 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621728000000",
"number": "1205401288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 COLONIAL CENTER PKWY STE 100N",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300764892",
"telephone_number": "770-999-9479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12669 PROMENADE ESTATES BLVD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342383512",
"telephone_number": "941-400-5033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEROLD",
"first_name": "KENDAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-23",
"last_updated": "2021-05-23",
"certification_date": "2021-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC009185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.