Active NPI
Kristin Vergo, MA, LMFT, LPC, LCMHC
- Mental Health Counselor
- Winston-Salem, NC
National Provider Identifier
1508309444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 632 Holly Ave NW
Winston-Salem, NC 27101 - Phone
- (720) 263-7386
- NPI assigned
- Nov 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
632 Holly Ave NW
Winston-Salem, NC 27101
Mailing address
632 Holly Ave NW
Winston-Salem, NC 27101
Phone (720) 263-7386
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 13, 2025 through Aug 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1508309444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 HOLLY AVE NW",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "27101",
"telephone_number": "720-263-7386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 HOLLY AVE NW",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "27101",
"telephone_number": "720-263-7386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGO",
"first_name": "KRISTIN",
"credential": "MA, LMFT, LPC, LCMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-26",
"last_updated": "2024-02-27",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston-Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.