Active NPI
Kandace Koontzperryman, LPC, NCC, MA
- Professional Counselor
- High Point, NC
National Provider Identifier
1730295072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4873
- Practice address
- 1312 Hamilton PL
St. 105
High Point, NC 27262 - Phone
- (336) 885-2116
- NPI assigned
- Aug 21, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4873 | NC | Primary |
Addresses
Primary practice location
1312 Hamilton PL
St. 105
High Point, NC 27262
Mailing address
1312 Hamilton Place
Suite 105
High Point, NC 27262
Phone (336) 885-2116
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 |
|---|---|---|---|
| 4873 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chrysalis | 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.
-
- Mental Health Counselor
- High Point, NC
- NPI 1346573417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730295072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 HAMILTON PLACE",
"address_2": "SUITE 105",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "27262",
"telephone_number": "336-885-2116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 HAMILTON PL",
"address_2": "ST. 105",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "27262",
"telephone_number": "336-885-2116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOONTZPERRYMAN",
"first_name": "KANDACE",
"name_prefix": "Mrs.",
"credential": "LPC, NCC, MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.