Active NPI
Kristina Peckins, LMHC
- Mental Health Counselor
- Nyack, NY
National Provider Identifier
1689002016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 004986
- Practice address
- 48 Burd St
Suite 206
Nyack, NY 10960-3226 - Phone
- (845) 641-3032
- NPI assigned
- Oct 22, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 004986 | NY | Primary |
Addresses
Primary practice location
48 Burd St
Suite 206
Nyack, NY 10960-3226
Mailing address
562 Kensico CT
Suffern, NY 10901-4159
Phone (845) 641-3032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 24, 2024 through May 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1689002016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "562 KENSICO CT",
"city": "SUFFERN",
"state": "NY",
"postal_code": "109014159",
"telephone_number": "845-641-3032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 BURD ST",
"address_2": "SUITE 206",
"city": "NYACK",
"state": "NY",
"postal_code": "109603226",
"telephone_number": "845-641-3032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECKINS",
"first_name": "KRISTINA",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-22",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "004986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.