Active NPI
Kristine Costello Davis, PLMSW
- Counselor
- Fayetteville, AR
National Provider Identifier
1265794218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2153 E Joyce Blvd
Fayetteville, AR 72703-4714 - Phone
- (479) 636-0083
- Fax
- (479) 636-0144
- NPI assigned
- Jun 14, 2012
- 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 | Primary |
Addresses
Primary practice location
2153 E Joyce Blvd
Fayetteville, AR 72703-4714
Mailing address
PO Box 383
Noel, MO 64854-0383
Phone (417) 475-6459
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339632000000",
"number": "1265794218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 383",
"city": "NOEL",
"state": "MO",
"postal_code": "648540383",
"telephone_number": "417-475-6459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2153 E JOYCE BLVD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034714",
"telephone_number": "479-636-0083",
"fax_number": "479-636-0144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KRISTINE",
"middle_name": "COSTELLO",
"name_prefix": "Mrs.",
"credential": "PLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-14",
"last_updated": "2012-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.