Individual provider Active NPI

Kristin Hardin Powell, BA, MS, LCSW

  • Clinical Social Worker
  • Lumberton, TX
National Provider Identifier
1700516077
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107215 Issued in TX
Practice address
105 Canyon Lake Cir
Lumberton, TX 77657-3701
Phone
(409) 200-2220
Fax
(409) 440-3344
NPI assigned
Jun 10, 2022
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 107215 TX
Clinical Social Worker 1041C0700X 107215 TX Primary

Addresses

Primary practice location

105 Canyon Lake Cir
Lumberton, TX 77657-3701

Mailing address

105 Canyon Lake Cir
Lumberton, TX 77657-3701
Phone (409) 200-2220

Other practice location 1

4749 Odom Rd
Beaumont, TX 77706-7080
Phone (409) 200-2220

Other names 1

  • Krsti Anissa Hardin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026002576 TX Practitioner - Clinical Social Worker 1052787421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newpath GroupGroup PAC ID 8820315138, 17 clinicians

Practice addresses (Care Compare)

105 Canyon Lake Cir
Lumberton, TX 77657-3701
Phone (409) 200-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
107215TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Newpath Group Mental Health CurrentSince Oct 12, 2022 Accepting new patients

Locations

4749 Odom Rd
Beaumont, TX 77706
Phone (409) 200-2220

105 Canyon Lake Cir
Lumberton, TX 77657
Phone (409) 200-2220

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, 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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1700516077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CANYON LAKE CIR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776573701",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CANYON LAKE CIR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776573701",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4749 Odom Rd",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777067080",
            "country_code": "US",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KRISTIN",
        "middle_name": "HARDIN",
        "credential": "BA, MS, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "107215",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "107215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRSTI",
            "last_name": "HARDIN",
            "middle_name": "ANISSA",
            "credential": "BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lumberton, TX

Sources for this page

Verify at the official NPI Registry.