Active NPI
Kyndall R Daniels, AAC
- Counselor
- Centralia, WA
National Provider Identifier
1245973221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 61296777
- Practice address
- 1126 S Gold St
Centralia, WA 98531-3768 - Phone
- (360) 807-4929
- Fax
- (360) 807-4160
- NPI assigned
- Apr 18, 2022
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 61296777 | WA | Primary |
Addresses
Primary practice location
1126 S Gold St
Centralia, WA 98531-3768
Mailing address
PO Box 2394
Longview, WA 98632-8455
Phone (360) 200-5419
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 |
|---|---|---|---|
| 61296777 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Health | Current | Accepting new patients |
Locations
1126 S Gold St
Centralia, WA 98531
Phone (360) 807-4929
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Longview, WA
- NPI 1639693781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650240000000",
"number": "1245973221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2394",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986328455",
"telephone_number": "360-200-5419",
"fax_number": "360-200-6736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 S GOLD ST",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985313768",
"telephone_number": "360-807-4929",
"fax_number": "360-807-4160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "KYNDALL",
"middle_name": "R",
"credential": "AAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-18",
"last_updated": "2022-04-18",
"certification_date": "2022-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "61296777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.