Kristina Beth Kelly-Snow, MS IN MENTAL HEALTH

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0071611 Issued in NY

Practice address

80 State Highway 310 Ste 1
Canton, NY 13617-1436

Phone

(315) 386-2167

Fax

(315) 268-0200

NPI assigned

Jul 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristina Beth Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• St Lawrence County

  • Community/Behavioral Health Agency
  • Canton, NY
  • NPI 1699898635
  NPD (past)
• St Lawrence County

  • Multi-Specialty Clinic/Center
  • Canton, NY
  • NPI 1861551822
  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1447667878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310, SUITE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "13617",
            "telephone_number": "315-386-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310 STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171436",
            "telephone_number": "315-386-2167",
            "fax_number": "315-268-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-SNOW",
        "first_name": "KRISTINA",
        "middle_name": "BETH",
        "credential": "MS IN MENTAL HEALTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P93595",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "0071611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "KELLY",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam David Jaffe
• Ralph M Johns, PSYD
• Renae Lynn Johnson, RN
• Trevor Allen Johnson, PT, DPT
• Eyal Kedar, M.D.
• Pamela Jane Kempshepherd, SLP
• Deborah Ann Kent, RN
• Alison Kern, CD
• Brian Richard Kerrigan, D.O.
• Jesse J Kibert, PA

• Mental Health Counselor in Canton, NY
• Providers in Canton, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.