Active NPI
Kristian Jay Mastin, MC, LAC
- Counselor
- Mesa, AZ
National Provider Identifier
1245720663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LAC-17112
- Practice address
- 2345 S Alma School Rd Ste 102
Mesa, AZ 85210-4013 - Phone
- (480) 278-9044
- NPI assigned
- May 10, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LAC-17112 | AZ | Primary |
Addresses
Primary practice location
2345 S Alma School Rd Ste 102
Mesa, AZ 85210-4013
Mailing address
2345 S Alma School Rd Ste 102
Mesa, AZ 85210-4013
Phone (480) 278-9044
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 |
|---|---|---|---|
| LAC-17112 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525910400000",
"number": "1245720663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2345 S ALMA SCHOOL RD STE 102",
"city": "MESA",
"state": "AZ",
"postal_code": "852104013",
"telephone_number": "480-278-9044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2345 S ALMA SCHOOL RD STE 102",
"city": "MESA",
"state": "AZ",
"postal_code": "852104013",
"telephone_number": "480-278-9044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTIN",
"first_name": "KRISTIAN",
"middle_name": "JAY",
"name_prefix": "Mr.",
"credential": "MC, LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-10",
"last_updated": "2018-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LAC-17112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.