Active NPI
Kristi R Machica, LPC, RPT-S
- Professional Counselor
- Ballwin, MO
National Provider Identifier
1861152753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2010031659
- Practice address
- 301 Sovereign CT
Ballwin, MO 63011-4441 - Phone
- (636) 338-1864
- NPI assigned
- Dec 20, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 2010031659 | MO | Primary |
Addresses
Primary practice location
301 Sovereign CT
Ballwin, MO 63011-4441
Mailing address
301 Sovereign CT
Ballwin, MO 63011-4441
Phone (636) 338-1864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 5, 2024 through Apr 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010031659 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1861152753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 SOVEREIGN CT",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630114441",
"telephone_number": "636-338-1864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 SOVEREIGN CT",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630114441",
"telephone_number": "636-338-1864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHICA",
"first_name": "KRISTI",
"middle_name": "R",
"credential": "LPC, RPT-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-20",
"last_updated": "2021-12-20",
"certification_date": "2021-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2010031659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.