Kirklin Kinney, LPC, PS, ADCII

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

141946 Issued in AK

Practice address

5801 E Bogard Rd
Wasilla, AK 99654-4267

Phone

(907) 352-3252

Fax

(907) 352-3373

NPI assigned

Apr 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AK

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 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mat - Su Health Services Inc.Group PAC ID 2567354533, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Mat - Su Health Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wasilla, AK
  • NPI 1184725210
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1437778602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 W SPRUCE AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545327",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996544267",
            "telephone_number": "907-352-3252",
            "fax_number": "907-352-3373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1363 W Spruce Ave",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "99654",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 E Dahlia Ave Ste M",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "996456463",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3261 S Big Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Big Lake",
            "state": "AK",
            "postal_code": "996239663",
            "country_code": "US",
            "telephone_number": "907-376-2411",
            "fax_number": "907-352-3363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "KIRKLIN",
        "credential": "LPC, PS, ADCII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "141946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA",
            "identifier": "141946",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KKINNEY@MATSUHEALTHSERVICES.ORG",
            "affiliation": "N",
            "endpointDescription": "ENCRYPTED EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5801 E Bogard Rd",
            "city": "Wasilla",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996544267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hailey Maddison Kincheloe, LMT
• Canyon King
• Elisa King
• Jami A King
• Justice Kinne
• Kristina Ann Kinney, LPC
• Kathleen Kirby
• Aleshia Marie Kirchner, M.ED
• Kristopher Kirchner
• Bethany Ellen Kirillov, CDM

• Professional Counselor in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Professional Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.