Individual provider Active NPI

Krystal Faye Kalb-Weldy, LMHC, RPT

  • Mental Health Counselor
  • South Bend, IN
National Provider Identifier
1467706499
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002401A Issued in IN
Practice address
2106 Ironwood Cir
South Bend, IN 46635-1864
Phone
(574) 243-9370
Fax
(574) 243-9375
NPI assigned
Oct 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39002401A IN Primary
Mental Health Counselor 101YM0800X 0701005175 VA

Addresses

Primary practice location

2106 Ironwood Cir
South Bend, IN 46635-1864

Mailing address

2106 Ironwood Cir
South Bend, IN 46635-1864
Phone (574) 243-9370

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
39002401AINMDMental Health Counselor
0701005175VAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1467706499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351864",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351864",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALB-WELDY",
        "first_name": "KRYSTAL",
        "middle_name": "FAYE",
        "credential": "LMHC, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002401A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701005175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.