Individual provider Active NPI

Kristin Leigh Puleo, LMHC

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1346687829
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00862 Issued in NY
Practice address
5411 NE 107TH Ave Ste 101
Vancouver, WA 98662-6347
Phone
(360) 828-7871
Fax
(360) 828-5636
NPI assigned
May 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 00862 NY Primary

Addresses

Primary practice location

5411 NE 107TH Ave Ste 101
Vancouver, WA 98662-6347

Mailing address

5411 NE 107TH Ave Ste 101
Vancouver, WA 98662-6347
Phone (360) 828-7871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241008003482 NY Practitioner - Mental Health Counselor 4284016478 Reassigns benefits to 1 organization
I20250207001741 WA Practitioner - Mental Health Counselor 4284016478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00862NYMDMental Health Counselor
008692NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage NW Consulting LLC Counselor CurrentSince Dec 1, 2024 Accepting new patients
Rising Buffalo Mental Health Counseling PLLC Mental Health CurrentSince Dec 1, 2023 Accepting new patients
MCCD Psychiatry Services PLLC CurrentSince Oct 7, 2024 Accepting new patients

Locations

375 Dick Rd
Ste 2
Depew, NY 14043
Phone (716) 416-9201

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

5411 NE 107th Ave
Ste 101
Vancouver, WA 98662
Phone (360) 828-7871

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1346687829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 NE 107TH AVE STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626347",
            "telephone_number": "360-828-7871",
            "fax_number": "360-828-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 NE 107TH AVE STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626347",
            "telephone_number": "360-828-7871",
            "fax_number": "360-828-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULEO",
        "first_name": "KRISTIN",
        "middle_name": "LEIGH",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "00862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.