Active NPI
Jennifer Kondroik
- Mental Health Counselor
- Luling, LA
National Provider Identifier
1598067548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8870
- Practice address
- 843 Milling Ave
Luling, LA 70070-4442 - Phone
- (985) 785-5800
- Fax
- (985) 785-5811
- NPI assigned
- Nov 24, 2010
- Last updated
- Nov 24, 2010
- 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 | 8870 | LA | Primary |
Addresses
Primary practice location
843 Milling Ave
Luling, LA 70070-4442
Mailing address
843 Milling Ave
Luling, LA 70070-4442
Phone (985) 785-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8870 | Other | LA | STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8870 | LA | MD | Mental Health Counselor |
Interoperability endpoints
- jennifer.kondroik.1@11331.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290556800000",
"number": "1598067548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "843 MILLING AVE",
"city": "LULING",
"state": "LA",
"postal_code": "700704442",
"telephone_number": "985-785-5800",
"fax_number": "985-785-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "843 MILLING AVE",
"city": "LULING",
"state": "LA",
"postal_code": "700704442",
"telephone_number": "985-785-5800",
"fax_number": "985-785-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONDROIK",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-24",
"last_updated": "2010-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": "8870",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "8870",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Luling, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.