Krystal Ann Smith

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.018264 Issued in IL

Practice address

12151 Regency Pkwy Ste 12169
Huntley, IL 60142-7644

Phone

(815) 331-8768

Fax

(815) 331-8760

NPI assigned

Sep 6, 2016

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

Medicare enrollment (NPD)

Not enrolled

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.

• Life Solutions: Integrative Healing & Well Being LLC

  • Mental Health Counselor
  • Dekalb, IL
  • NPI 1720462799
  NPD (past)

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1487101564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12151 REGENCY PKWY STE 12169",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427644",
            "telephone_number": "815-331-8768",
            "fax_number": "815-331-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12151 REGENCY PKWY STE 12169",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427644",
            "telephone_number": "815-331-8768",
            "fax_number": "815-331-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRYSTAL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simpson Eye Associates LTD
• Lisa Marie Sloka, LMFT
• Jacob Smerecky, RD, LDN
• Smiles by Farr, LTD.
• Kelly Jean Smith, PHARM.D.
• Mohammad Asim Sohail, M.D.
• Solace Ocdanxiety Therapy, PLLC
• Clifford Song, M.D.
• SSD Medical Group Inc
• Xochitl Maria Stankiewicz, S.L.

• Professional Counselor in Huntley, IL
• Providers in Huntley, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.