Individual provider Active NPI

Kristen Perrine

  • Mental Health Counselor
  • Fort Valley, GA
National Provider Identifier
1548085541
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
410 E Church St
Fort Valley, GA 31030-3097
Phone
(229) 591-4000
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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 Primary

Addresses

Primary practice location

410 E Church St
Fort Valley, GA 31030-3097

Mailing address

122 W Forsyth St
Americus, GA 31709-3561
Phone (229) 591-4000

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

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1548085541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W FORSYTH ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093561",
            "telephone_number": "229-591-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E CHURCH ST",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310303097",
            "telephone_number": "229-591-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRINE",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Valley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.