Active NPI
Ingrid Jean Krecko, M.A.
- Clinical Psychologist
- Augusta, KS
National Provider Identifier
1629478136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2790
- Practice address
- 2821 Brookside CT
Augusta, KS 67010-2433 - Phone
- (316) 425-0073
- Fax
- (316) 260-7909
- NPI assigned
- Sep 3, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2790 | KS | Primary |
Addresses
Primary practice location
2821 Brookside CT
Augusta, KS 67010-2433
Mailing address
2821 Brookside CT
Augusta, KS 67010-2433
Phone (316) 425-0073
Other practice location 1
163 Plaza Rd
Indiana, PA 15701-3264
Phone (724) 465-2311
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2790 | KS | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Psychological Services | Clinical | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1629478136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 BROOKSIDE CT",
"city": "AUGUSTA",
"state": "KS",
"postal_code": "670102433",
"telephone_number": "316-425-0073",
"fax_number": "316-260-7909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 BROOKSIDE CT",
"city": "AUGUSTA",
"state": "KS",
"postal_code": "670102433",
"telephone_number": "316-425-0073",
"fax_number": "316-260-7909"
}
],
"practiceLocations": [
{
"address_1": "163 Plaza Rd",
"address_purpose": "LOCATION",
"city": "Indiana",
"state": "PA",
"postal_code": "157013264",
"country_code": "US",
"telephone_number": "724-465-2311",
"fax_number": "724-465-2339",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRECKO",
"first_name": "INGRID",
"middle_name": "JEAN",
"name_prefix": "Miss",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-03",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "2790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.