Kristin Moulton

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

121626-13 Issued in IL

Practice address

3640 W Fillmore St
Chicago, IL 60624-4309

Phone

(773) 290-5891

NPI assigned

Jul 23, 2021

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kristin.moulton.1@27315.direct.athenahealth.com

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.

• Tapestry 360 Health

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1407981392
  NPD (past)

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1447823695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N GREENVIEW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606264208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 W FILLMORE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244309",
            "telephone_number": "773-290-5891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6700 N Greenview Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606264208",
            "country_code": "US",
            "telephone_number": "773-366-7704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "121626-13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Frederic Motzel, ALMFT
• Alaa Mouhajer
• Tamer Moukaied, DDS
• John Paul Moulder, MDIV, MA
• Zineb Moulekaf
• Theresa S Moulton, PT
• Sarah Jane Moum, M.D.
• Mount Carmel Medical Center
• Mount Sinai
• Mount Sinai Children'S Hospital

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.