Kristen St Clair Miciotto, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

70202 Issued in TX

Practice address

2525 Wallingwood Dr
Austin, TX 78746-6900

Phone

(512) 626-5719

NPI assigned

Jun 27, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427579762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 COHOBA DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787485083",
            "telephone_number": "512-626-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WALLINGWOOD DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787466900",
            "telephone_number": "512-626-5719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W William Cannon Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787455281",
            "country_code": "US",
            "telephone_number": "512-344-9181",
            "fax_number": "512-344-9135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICIOTTO",
        "first_name": "KRISTEN",
        "middle_name": "ST CLAIR",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "70202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.