Kirsten Louise Jettinghoff, L.C.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC2729 Issued in ME

Practice address

100 Gray Rd
Falmouth, ME 04105-2018

Phone

(207) 671-4325

NPI assigned

Oct 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kirsten.jettinghoff.p1@direct.chcfhc.nextgenshare.com

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.

• Elemental Shift LLC

  • Adult Mental Health Clinic/Center
  • Salem, MA
  • NPI 1992418446
  NPD Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1750476586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PINEWOOD DR",
            "city": "CUMBERLAND",
            "state": "ME",
            "postal_code": "040214043",
            "telephone_number": "207-671-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAY RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052018",
            "telephone_number": "207-671-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTINGHOFF",
        "first_name": "KIRSTEN",
        "middle_name": "LOUISE",
        "credential": "L.C.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC2729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431730699",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrative Manual Therapy Associates
• Irina Babayan, DDS, PA
• Ahmed Jaber
• Ellen Marie Jackson, LCSW
• Cathy M Janelle, MS, CCC/SLP, LSLS
• Kimberly Johnson, LMT, OMT
• Monique Angella Johnson, PHARM.D.
• Jennifer Jones, LCSW
• Tammy J. C. Jones, COTA
• David A Jordan, LCPC, CCS

• Professional Counselor in Falmouth, ME
• Providers in Falmouth, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.