Kristin Park, MSMFT, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT-6819 Issued in ID

Practice address

1910 Northwest Blvd Ste 206
Coeur D Alene, ID 83814-2676

Phone

(208) 219-7043

NPI assigned

Mar 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
  • NPI 1194397240

  Marriage & Family Therapist

  NPD (past)
• Dirne Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coeur D Alene, ID
  • NPI 1255756730

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1316364342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 NORTHWEST BLVD STE 206",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142676",
            "telephone_number": "208-219-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 NORTHWEST BLVD STE 206",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142676",
            "telephone_number": "208-219-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "MSMFT, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-6819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Michele Pankratz
• Craig James Panos, M. D.
• Erica Lynn Panttaja, APRN
• Patrick John Parden, M.D.
• Jamie Lee Park, PHARM.D.
• Travis Anthony Park, PHARMD.
• Courtney L Parker, NP
• David Parker, MD
• Hinah Gul Parker
• Ralph E Parkison, LCSW

• Marriage & Family Therapist in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.