Kristina Sylla Fury

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MG61042067 Issued in WA

Practice address

2525 NE 195TH St Apt 101
Lake Forest Park, WA 98155-1460

Phone

(925) 478-1258

NPI assigned

Aug 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1316558927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NE 195TH ST APT 101",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981551460",
            "telephone_number": "925-478-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 195TH ST APT 101",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981551460",
            "telephone_number": "925-478-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURY",
        "first_name": "KRISTINA",
        "middle_name": "SYLLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": "MG61042067",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MG61042067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas L. Fasnacht
• Bethany Field
• Rebecca Foglietti
• Fred Ebsworth DDS PS
• Rachelle M Friskey, LMHCA
• Clarissa Garza, LMHC-A
• Robert Allison Gotshall, MD
• Infinitasks LLC
• Shari Syrdal Jaques, ARNP MN
• Anthony Reed Johnson, LMP

• Counselor in Lake Forest Park, WA
• Providers in Lake Forest Park, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.