Christina Kittstein LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CHRISTINA KITTSTEIN LLC

Practice address

6209 E Main St
Maryville, IL 62062-2015

Phone

(618) 979-7301

Fax

(888) 972-8757

NPI assigned

May 8, 2020

Organization subpart

No

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

Authorized official

Name

Christina Kittstein, LCPCNPI 1518073683

Title

Manager

Phone

(618) 979-7301

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christina Kittstein, LLC

  • Mental Health Counselor
  • Maryville, IL
  • NPI 1518073683
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588896000000",
    "number": "1427670819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10104 STATE ROUTE 4",
            "city": "LEBANON",
            "state": "IL",
            "postal_code": "622542612",
            "telephone_number": "618-979-7301",
            "fax_number": "888-972-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 E MAIN ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620622015",
            "telephone_number": "618-979-7301",
            "fax_number": "888-972-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINA KITTSTEIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A",
        "authorized_official_last_name": "KITTSTEIN",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "618-979-7301",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryville, IL
• Providers in Maryville, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.