Individual provider Active NPI

Karissa J Collins, MFT I88089

  • Mental Health Counselor
  • Huntington Beach, CA
National Provider Identifier
1447747233
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
81-4091538 Issued in CA
Practice address
17111 Beach Blvd Ste 205
Huntington Beach, CA 92647-5947
Phone
(714) 654-1570
Fax
(844) 533-6952
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 81-4091538 CA Primary

Addresses

Primary practice location

17111 Beach Blvd Ste 205
Huntington Beach, CA 92647-5947

Mailing address

619 16TH St
Huntington Beach, CA 92648-4015
Phone (714) 330-9695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
81-4091538CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1447747233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 16TH ST",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484015",
            "telephone_number": "714-330-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17111 BEACH BLVD STE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475947",
            "telephone_number": "714-654-1570",
            "fax_number": "844-533-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KARISSA",
        "middle_name": "J",
        "credential": "MFT I88089",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "81-4091538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

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