Michelle Kistner, LPCC-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0500956-SUPV Issued in OH

Practice address

22251 State Route 2
Archbold, OH 43502-9452

Phone

(419) 445-1552

Fax

(419) 445-1401

NPI assigned

Aug 5, 2007

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shalom MinistriesGroup PAC ID 7911376033, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shalom Ministries

  dba Shalom Counseling & Mediation Center

  • Community/Behavioral Health Agency
  • Archbold, OH
  • NPI 1366573552
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1750572863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 HIGHLAND AVE",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435451104",
            "telephone_number": "419-438-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22251 STATE ROUTE 2",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435029452",
            "telephone_number": "419-445-1552",
            "fax_number": "419-445-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTNER",
        "first_name": "MICHELLE",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C0500956",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0500956-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kiernan, PT
• Kayla Marie Kimble, PA-C
• Christian A King, O.D.
• Dagmar King
• Kings Vision Center
• Leah Kleman
• Jamie Knueven
• Jenny Krauss
• Robyn Kuhlman
• David Michael Lamb

• Mental Health Counselor in Archbold, OH
• Providers in Archbold, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.