Individual provider Active NPI

Kristina Stewart, M.A.

  • Mental Health Counselor
  • Green Cove Springs, FL
National Provider Identifier
1629604301
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2635 Creekfront Dr
Green Cove Springs, FL 32043-6222
Phone
(904) 290-1634
NPI assigned
Mar 13, 2020
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

2635 Creekfront Dr
Green Cove Springs, FL 32043-6222

Mailing address

2635 Creekfront Dr
Green Cove Springs, FL 32043-6222
Phone (904) 290-1634

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired to Heal, Inc Mental Health CurrentSince Dec 17, 2023 Accepting new patients
Integrative Social Services LLC PastSince Mar 22, 2020 Accepting new patients
Lets Talk Openly LLC PastSince Jun 18, 2023 Accepting new patients

Locations

1045 N Orange Ave
#1
Green Cove Springs, FL 32043
Phone (904) 290-1634

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1629604301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 CREEKFRONT DR",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320436222",
            "telephone_number": "904-290-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 CREEKFRONT DR",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320436222",
            "telephone_number": "904-290-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KRISTINA",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Cove Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.