Individual provider Active NPI

Kristen L Pepera, LPCC

  • Professional Counselor
  • Fairview Park, OH
National Provider Identifier
1255605689
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1100213 Issued in OH
Practice address
21139 Lorain Rd Ste 12
Fairview Park, OH 44126-2149
Phone
(330) 529-5667
NPI assigned
Mar 2, 2012
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1100213 OH Primary

Addresses

Primary practice location

21139 Lorain Rd Ste 12
Fairview Park, OH 44126-2149

Mailing address

1371 Marview Dr
Westlake, OH 44145-2339
Phone (330) 204-0457

Other practice location 1

554 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 984-3882

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

LicenseStateTypeSpecialty
E.1100213OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Colors Plus Counseling CurrentSince Aug 4, 2024 Accepting new patients

Locations

21139 Lorain Rd
Ste 12
Fairview Park, OH 44126
Phone (330) 529-5667

20525 Center Ridge Rd
Ste 134
Rocky River, OH 44116
Phone (216) 200-8814

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1255605689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 MARVIEW DR",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452339",
            "telephone_number": "330-204-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21139 LORAIN RD STE 12",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262149",
            "telephone_number": "330-529-5667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "554 N Leavitt Rd",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "OH",
            "postal_code": "440011131",
            "country_code": "US",
            "telephone_number": "440-984-3882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEPERA",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1100213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.