Kristin J Charlesworth, PLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2011039647 Issued in MO

Practice address

107 Ward Ter
Crystal City, MO 63019-1707

Phone

(314) 546-5242

NPI assigned

Dec 12, 2011

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

Other names 1

• Miss Kristin J Straub Former name

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.

• Family and Community Therapy Services, LLC

  • Professional Counselor
  • Crystal City, MO
  • NPI 1467895235
  NPD (past) Authorized official

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1619245149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WARD TER",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "630191707",
            "telephone_number": "314-546-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WARD TER",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "630191707",
            "telephone_number": "314-546-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLESWORTH",
        "first_name": "KRISTIN",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2011039647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "STRAUB",
            "middle_name": "J",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lynne Amptman
• Allyson Barto, PHARMD
• Diana Blackwell, LCSW
• Christopher M Cabral, PT, DPT
• Jessica Cantrell, MA, LPC
• Darcy M Clawson, P.A.-C
• Talon Colby
• Colonial House of Crystal City, LLC
• Compass Health, Inc
• Compass Health, Inc

• Professional Counselor in Crystal City, MO
• Providers in Crystal City, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.