Individual provider Active NPI

Krystal Nakita Robinson, LMFT

  • Marriage & Family Therapist
  • Waycross, GA
National Provider Identifier
1306419866
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001886 Issued in GA
Practice address
1003 Mary St
Waycross, GA 31503-3823
Phone
(912) 449-7100
Fax
(912) 449-7060
NPI assigned
Jul 22, 2021
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001886 GA Primary

Addresses

Primary practice location

1003 Mary St
Waycross, GA 31503-3823

Mailing address

1007 Mary St
Waycross, GA 31503-3823
Phone (912) 449-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260320002650 GA Practitioner - Marriage and Family Therapist 4385128933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1007 Mary St
Waycross, GA 31503-3899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT001886GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Unison Behavioral Health PastSince Jul 25, 2021 Accepting new patients

Organizations & group practices 2

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": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1306419866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7111",
            "fax_number": "912-449-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7100",
            "fax_number": "912-449-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "KRYSTAL",
        "middle_name": "NAKITA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.