Kristina Diane Slate, LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

63609 Issued in TX

Practice address

147 Wagon Wheel Dr
Waxahachie, TX 75167-4830

Phone

(469) 337-0111

NPI assigned

Jul 1, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1669099099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 N HIGHWAY 77 STE 501C",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751651985",
            "telephone_number": "469-337-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 WAGON WHEEL DR",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751674830",
            "telephone_number": "469-337-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATE",
        "first_name": "KRISTINA",
        "middle_name": "DIANE",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Waxahchie",
            "affiliation": "N",
            "address_1": "147 Wagon Wheel Dr",
            "city": "Waxahachie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751674830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Waxahachie, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.