Active NPI
Kristi Wilson Myricks, LPC
- Professional Counselor
- Birmingham, AL
National Provider Identifier
1609201391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 1733 Brookfield LN
Birmingham, AL 35214-4837 - Phone
- (205) 960-3303
- Fax
- (205) 326-8606
- NPI assigned
- Sep 12, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
1733 Brookfield LN
Birmingham, AL 35214-4837
Mailing address
1733 Brookfield LN
Birmingham, AL 35214-4837
Phone (205) 960-3303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240417001496 | AL | Practitioner - Mental Health Counselor | 2769821255 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Mental Health Services LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Birmingham, AL
- NPI 1043766009
AL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1609201391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 BROOKFIELD LN",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352144837",
"telephone_number": "205-960-3303",
"fax_number": "205-326-8606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1733 BROOKFIELD LN",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352144837",
"telephone_number": "205-960-3303",
"fax_number": "205-326-8606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYRICKS",
"first_name": "KRISTI",
"middle_name": "WILSON",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-12",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.