Active NPI
Kandy Pauline Konruff, LMHP
- Mental Health Counselor
- North Platte, NE
National Provider Identifier
1255486718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1575
- Practice address
- 509 E 4TH St Ste C
North Platte, NE 69101-6943 - Phone
- (308) 520-4213
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 1575 | NE | Primary |
Addresses
Primary practice location
509 E 4TH St Ste C
North Platte, NE 69101-6943
Mailing address
PO Box 731
North Platte, NE 69103
Phone (308) 520-4213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025097300 | Medicaid | NE |
Other names 1
- Kandy Miller Hendrickson
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 |
|---|---|---|---|
| 1575 | NE | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697673600000",
"number": "1255486718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 731",
"city": "NORTH PLATTE",
"state": "NE",
"postal_code": "69103",
"telephone_number": "308-520-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 E 4TH ST STE C",
"city": "NORTH PLATTE",
"state": "NE",
"postal_code": "691016943",
"telephone_number": "308-520-4213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONRUFF",
"first_name": "KANDY",
"middle_name": "PAULINE",
"credential": "LMHP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2023-10-19",
"certification_date": "2023-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "1575",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025097300",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KANDY",
"last_name": "HENDRICKSON",
"middle_name": "MILLER",
"code": "5",
"type": "Other Name"
}
]
}Other providers in North Platte, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.